Relief of post-herpetic neuralgia by surgical removal of painful skin: 5 years later |
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Authors: | Petersen Karin Lottrup Rowbotham Michael C |
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Institution: | UCSF Pain Clinical Research Center, Department of Neurology, University of California, San Francisco, CA 94115, USA. karin.petersen@ucsf.edu |
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Abstract: | Surgical removal of painful skin was first attempted as a treatment for chronic intractable post-herpetic neuralgia (PHN) more than a century ago, but long-term follow-up has rarely been reported. A patient who underwent surgical excision of 294cm(2) of thoracic skin comprising the entire area of pain and allodynia in October 2000 has been followed for 5.5years post-surgery. Our initial report presented evidence of benefit in the form of reduced pain, elimination of allodynia, and reduced medication consumption during the first post-operative year. Unfortunately, pain steadily increased and now exceeds pre-surgery levels despite increased medication use. Pain topography and characteristics are different from pre-surgery and may relate to the pathophysiology of PHN. Skin resection cannot be recommended as a treatment for PHN. |
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