The Effect of 0.5% Sodium Tetradecyl Sulfate on a Venous Lake Lesion

BackgroundA venous lake lesion is a venous ectasia that occurs on the exposed skin of elderly people. Although a number of therapies such as surgical excision, laser therapy, infrared coagulation, cryotherapy and sclerotherapy have been used to treat venous lakes, there is no guideline for treating this lesion.ObjectiveThe purpose of this study was to determine whether 0.5% sodium tetradecyl sulfate (STS) is effective for the treatment of venous lake lesions.MethodsTwelve patients with venous lake lesions were enrolled In this study. After proper antiseptic preparation, 0.5% STS was slowly injected into each subject''s lesion, and this was followed by immediate compression for 10 minutes.ResultsAfter treatment, all of the patients'' lesions cleared completely. The average number of treatments was 2.15±1.28. Two patients experienced mild side effects such as light pain and paresthesia, and these soon disappeared. There were no serious side effects reported during treatment. The mean follow up period was 29.58±13.48 months.ConclusionWe have demonstrated that sclerotherapy with 0.5% STS was quite effective for treating venous lake lesions, and this treatment caused no serious adverse effects.     

Immunotherapy with Intralesional Candida Albicans Antigen in Resistant or Recurrent Warts: A Study

Background:

Warts are sometimes resistant or they tend to recur after every possible destructive therapy. Immunotherapy with skin-test antigens has been used as a viable therapeutic option in such recalcitrant cases.

Aim:

The aim of the study was to evaluate the response of resistant or recurrent warts to intralesional Candida albicans antigen immunotherapy.

Materials and Methods:

A total of 40 patients with resistant or recurrent warts who showed a positive test reaction to C. albicans antigen were given intralesional injections of purified C. albicans antigen solution in a single wart at 3-weekly intervals for a total of three doses. The patients were monitored for resolution of the injected wart as well as other untreated warts. The patients who responded positively were then followed up for any relapses over the next 6 months. Adverse events, if any, were also documented.

Results:

Of the 40 patients enrolled in the study, 34 completed the total treatment protocol of three injections and 6 months of follow-up. In these 34 patients, 19 (56%) showed a complete resolution of warts at all places on the body. In addition, two patients (6%) showed a partial or complete resolution of the treated wart, but there was no effect on the untreated warts. Thirteenpatients (38%) failed to show any response to the treatment regimen. In all patients showing resolution of all the warts, there were no relapses at any site over the next 6 months of follow-up. The most common adverse effect seen was pain during the intralesional injection.

Conclusions:

Intralesional Candida immunotherapy seems to be an effective treatment option in more than half of the patients who fail to show a positive response to destructive modes of treatment or in whom there are multiple recurrences.

Limitations:

The small sample size and lack of control group are the main limitations of the study.     

Intralesional triamcinolone alone or in combination with botulinium toxin A is ineffective for the treatment of formed keloid scar: A double blind controlled pilot study

Cutaneous injury can ignite excessive fibroproliferative growth that results in keloid formation. Keloids are associated with significant morbidity related to disfigurement and/or symptoms (e.g., pain and pruritus). First‐line treatment of formed keloids involves topical or intralesional steroids. Recurrent or resistant keloids are managed by surgical excision or cryotherapy, followed by steroidal application or adjuvant irradiation. Although adjuvant irradiation appears to be most efficacious, alternative therapeutic options are needed for patients without access to radiation centers. Botulinum Toxin A (BTA) appears to have similar inhibitory effects to irradiation on the cell cycle via downregulation of pathogenic cytokines. Herein, we conducted a study to compare the efficacy of intralesional triamcinolone used alone, or in combination with BTA, in the treatment of formed keloid scars. Twenty patients with a cumulative of 40 keloids completed the study. There was no significant difference between treatment arms with respect to height vascularization, pliability, and pigmentation scores. The addition of BTA resulted in significant symptomatic improvement of pain and pruritus as compared to intralesional triamcinolone alone (p < 0.001). Irradiation is only effective when administered in the adjuvant setting where inhibitory effects on cell cycle and migration are optimized. Future studies with intralesional triamcinolone and BTA should be performed adjuvantly.     

夹脊穴注射糖皮质激素预防50岁以上带状疱疹后神经痛的meta分析

目的评价夹脊穴注射糖皮质激素对预防50岁以上患者带状疱疹后遗神经痛的疗效及安全性。方法计算机检索Cochrane Library、Pub Med、EMbase、CNKI、CBM、Wan Fang和VIP(从建库至2015年10月),纳入夹脊穴注射糖皮质激素或椎旁神经阻滞与空白或安慰剂对照治疗急性带状疱疹的随机对照试验,治疗组与对照组可结合或不结合基础治疗。由2名研究者按照Cochrane Handbook标准独立评价文献质量、提取数据并交叉核对,使用Rev Man5.3软件进行Meta分析。结果共纳入4个研究,合计1 374例患者。Meta分析结果显示:6个月时PHN的发生率试验组低于对照组[RR=0.39,95%CI(0.16,0.94)];除对照组出现1例严重不良反应外,其余均未报道严重不良反应。结论基于目前的证据,夹脊穴注射糖皮质激素可能预防或降低50岁以上患者PHN的发生率,且安全较好,但尚缺乏更多高质量的研究,目前还不能得到更为可靠的结论。