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Images in Paediatrics
Capillary malformation of the lower lip: CLAPO syndrome
Malformación capilar del labio inferior: síndrome CLAPO
Julio César Moreno Alfonsoa,d,
Corresponding author
juliomoreno.md@gmail.com

Corresponding author.
, Juan Carlos López Gutiérrezb, Paloma Elena Triana Juncob, María San Basilio Berenguerc
a Cirugía Pediátrica, Hospital Universitario de Navarra, Pamplona, Spain
b Cirugía Pediátrica, Cirugía Plástica y Anomalías Vasculares, Hospital Universitario La Paz, Madrid, Spain
c Cirugía Pediátrica, Hospital Universitario La Paz, Madrid, Spain
d Universidad Pública de Navarra, Pamplona, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Vascular malformations constitute a broad spectrum of disorders caused by the abnormal development of blood vessels&#46; Capillary malformations &#40;CMs&#41; are the most frequent type of vascular anomalies and affect up to 0&#46;3&#37; of the population&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of a boy aged 8 months referred to us on account of a CM of the lower lip&#44; lymphatic malformation &#40;LM&#41;&#44; asymmetry in the right side of the face &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41; and overgrowth of the first toe in both feet with bilateral sandal gap deformity &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B and C&#41;&#46; A PIK3CA-related overgrowth spectrum &#40;PROS&#41; syndrome was suspected&#44; prompting performance of a brain magnetic resonance scan that ruled out central nervous system involvement and leading to diagnosis of CLAPO syndrome&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">CLAPO syndrome is characterised by capillary vascular malformation of the lower lip&#44; lymphatic malformations of the head and neck&#44; asymmetry and partial&#47;generalized overgrowth<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; It is a sporadic disorder associated with somatic changes in the <span class="elsevierStyleItalic">PIK3CA</span> gene and other PROS syndromes&#44; such as megalencephaly-capillary malformation syndrome &#40;MCAP&#41;&#44; which explains the overlap of the phenotypes of these two syndromes<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; The CM of the lower lip is characteristic of CLAPO syndrome&#44; so in the case of a CM in the gums or lower lip&#44; it is important to monitor the patient for the development of a LM or overgrowth&#44; while in the case of a CM of the upper lip&#44; MCAP syndrome should be suspected and neurological involvement must be ruled out&#46; In this sense&#44; CMs are important findings that&#44; based on their location&#44; may guide the differential diagnosis with other underlying anomalies or syndromes&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">This research did not receive any external funding&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#41; Capillary malformation between the brows and in the lower lip &#40;arrow&#41; with right facial asymmetry &#40;arrowhead&#41;&#46; Overgrowth of the first toe of the feet &#40;arrowhead&#41; with bilateral sandal gap &#40;double-headed arrow&#41;&#58; B&#41; right foot&#44; C&#41; left foot&#46; Phenotype compatible with CLAPO syndrome&#46;</p>"
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                      "titulo" => "Capillary malformation of the lower lip&#44; lymphatic malformation of the face and neck&#44; asymmetry and partial&#47;generalized overgrowth &#40;CLAPO&#41;&#58; report of six cases of a new syndrome&#47;association"
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                      "titulo" => "CLAPO syndrome&#58; identification of somatic activating PIK3CA mutations and delineation of the natural history and phenotype"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Rodriguez-Laguna"
                            1 => "K&#46; Iba&#241;ez"
                            2 => "G&#46; Gordo"
                            3 => "S&#46; Garcia-Minaur"
                            4 => "F&#46; Santos-Simarro"
                            5 => "N&#46; Agra"
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                      "doi" => "10.1038/gim.2017.200"
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                        "tituloSerie" => "Genet Med"
                        "fecha" => "2018"
                        "volumen" => "20"
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