Local, non-systemic, and minimally invasive therapies for calcinosis cutis: a systematic review

AbstractCalcinosis cutis is a deposition of calcium in the skin and subcutaneous tissue, often accompanied by pain, reduced mobility, and chronic infections. Limited evidence is available about the feasibility and efficacy of therapies alternative to systemic treatment and surgical excision, both of which often lead to unsatisfactory results or complications. We conducted a systematic review to evaluate the efficacy and safety of topical and intralesional sodium thiosulfate, extracorporeal shock-wave lithotripsy (ESWL), and laser for calcinosis cutis. PubMed, Embase, and Web of Science were searched. Reports of calciphylaxis and treatment combined with systemic medications were excluded. A total of 40 studies including 136 patients were analysed. Partial or complete remission after monotherapy was observed in 64% to 81% of cases. Self-applied topical sodium thiosulfate required patient’s adherence (mean treatment duration, 4.9 months; range 2–24). Laser therapy enabled complete remission of microcalcifications after a single procedure (57%; 12/21). ESWL and intralesional sodium thiosulfate injections decreased calcinosis-associated pain (median reduction in VAS score, 3; range 0–9 and 1; range 0–5, respectively). The most common adverse event was scarring and hyperkeratosis, observed after CO2 laser (56%; 10/18). Intralesional sodium thiosulfate injections caused transient pain in over 11% of patients. Recurrences within the follow-up were rare (2%; 3/136). This study provides an overview of minimally invasive and local therapies that in selected cases might transcend conventional treatment. The limitation of this study is the poor level of evidence, which emerges mainly from non-randomized studies at high risk of bias.

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Topical sodium thiosulfate as treatment of calcinosis cutis: Case series and systematic review

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2021.09.013 ◽

2021 ◽

Author(s):

Jose W. Ricardo ◽

Helen Y. Sun ◽

Mahdieh Gorji ◽

Deshan F. Sebaratnam

Keyword(s):

Systematic Review ◽

Sodium Thiosulfate ◽

Case Series ◽

Calcinosis Cutis

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Updated Management of Malar Edema, Mounds, and Festoons: A Systematic Review

Aesthetic Surgery Journal ◽

10.1093/asj/sjz137 ◽

2019 ◽

Cited By ~ 1

Author(s):

C Ian Newberry ◽

Hilary Mccrary ◽

J Regan Thomas ◽

Eric W Cerrati

Keyword(s):

Systematic Review ◽

Minimally Invasive ◽

Scoping Review ◽

Treatment Algorithm ◽

Level Of Evidence ◽

Invasive Intervention

AbstractTo deliver a natural, aesthetically pleasing periorbital rejuvenation, restoration of the youthful lid-cheek junction and malar eminence is often essential. However, the management of malar bags is complex secondary to the diverse pathophysiology and varying severity of malar edema, mounds, and festoons. Treatment must be individualized based on extent and content. This scoping review updates the audience on the anatomy, pathophysiology, and evaluation of malar bags in addition to the latest literature regarding minimally invasive intervention and surgical refinements. A modernized treatment algorithm is proposed.Level of Evidence: 4

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Minimally Invasive Hallux Valgus Surgery. A Systematic Review

Albanian Journal of Trauma and Emergency Surgery ◽

10.32391/ajtes.v2i2.5 ◽

2018 ◽

Vol 2 (2) ◽

Author(s):

Edvin Selmani ◽

Fatmir Brahimi ◽

Leard Duraj ◽

Valbona Selmani ◽

Gjergji Syko ◽

...

Keyword(s):

Systematic Review ◽

Minimally Invasive ◽

Hallux Valgus ◽

Literature Search ◽

Minimally Invasive Procedures ◽

Percutaneous Surgery ◽

Invasive Procedures ◽

Level Of Evidence ◽

Level Ii ◽

Evidence Rating

This systematic review aims to illustrate the published results of “minimally invasive” procedures for correction of hallux valgus. Based on former systematic reviews on that topic, the literature search was organised by two independent investigators. MEDLINE was systematically searched for available studies. The keywords used were “hallux valgus”, “bunion”, “percutaneous surgery”, “minimally invasive surgery”, “arthroscopy”, “Bosch” and “SERI”. Studies were assessed using the level of evidence rating. A total of 21 papers were included in this review. These studies described a total of 1,750 patients with 2,195 instances of percutaneous, minimally invasive or arthroscopic hallux valgus surgery. Clinical reports of results after minimally invasive hallux valgus surgery at meetings are common. Published results in peer-reviewed journals are less common and the majority of papers are level IV studies according to the level of evidence ratings. We found one level II and three level III studies. Reported complications seem to be less than one may see in one’s own clinical practice. This possible bias may be related to the fact that most studies are published by centres performing primarily minimally invasive hallux valgus surgery.

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Minimally Invasive Pilonidal Sinus Treatment: A Brief Review

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7269 ◽

2021 ◽

Vol 9 (F) ◽

pp. 770-774

Author(s):

Danilo Coco ◽

Silvana Leanza

Keyword(s):

Minimally Invasive ◽

Pilonidal Sinus ◽

Subcutaneous Tissue ◽

Sinus Surgery ◽

Pilonidal Sinus Disease ◽

Chronic Infections ◽

Invasive Treatment ◽

Young Males ◽

Less Is More ◽

Disease Site

With a prevalence of 26/100,000, pilonidal sinus disease is a frequent natal cleft condition that primarily affects young males. The disease site is often uncomfortable and the disease can result in problems such as abscess formation and recurrent acute or chronic infections. Minimally invasive treatment aims to form a small elliptical wedge of subcutaneous tissue containing all the inflammatory tissue. The sinus and its lateral tracks are removed while keeping the overlying skin intact. Following the notion of “less is more,” novel least invasive treatments such as sinotomy, sinusectomy, trephining, and video-assisted and endoscopic pilonidal sinus surgery have recently been proposed. We look at minimally invasive treatments to explain how research into modern techniques has revealed a low rate of short-term problems.

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Percutaneous surgery in the treatment of Haglund syndrome

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2020.v14.1192 ◽

2020 ◽

Vol 14 (3) ◽

pp. 285-292

Author(s):

Marília Gomes ◽

Gabriel Monteiro ◽

José Arteiro Neto

Keyword(s):

Systematic Review ◽

Clinical Trial ◽

Minimally Invasive ◽

Success Rate ◽

Controlled Trial ◽

Meta Analysis ◽

Percutaneous Surgery ◽

Level Of Evidence ◽

Number Of Patients ◽

The Mean

Objective: The present study aimed to verify the state of the art of minimally invasive percutaneous surgical treatment for Haglund syndrome. Methods: This systematic review of the literature was based on a bibliographic survey in the PubMed, Medline and Embase databases. The descriptors "Haglund syndrome", "Haglund", "Achilles", "Minimally invasive", "Percutaneous surgery" and "Osteotomy" were used, in addition to the filters "Randomized Controlled Trial", "Randomized Clinical Trial", "Meta-Analysis", "Systematic Reviews", "Reviews", and "Clinical Trial". Results: A total of 37 articles were included. The total number of patients with Haglund syndrome treated in the included studies was 831 and 920. The mean patient age was 46.6 years (range, 28.7 to 61) and 58% were men. A higher success rate and a lower rate of complications were reported in men, and physically active patients had better treatment results. The mean success rate for minimally invasive percutaneous procedures was 83.4% (range 66 to 100%). Overall patient satisfaction was 77.5% (range 60 to 95%) and the complication rate was 6.3% (range 0 to 23%). Conclusion: Despite a lack of studies with the recommended evidence level, minimally invasive and percutaneous surgical treatments seem to be a good option for patients with Haglund syndrome when conservative treatment fails. Level of Evidence III; Therapeutic Studies; Systematic Review of Level III Studies.

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MINIMALLY INVASIVE LUMBAR ARTHRODESIS AND PERCUTANEOUS PEDICLE SCREWS: A SYSTEMATIC REVIEW

Coluna/Columna ◽

10.1590/s1808-185120201904228299 ◽

2020 ◽

Vol 19 (4) ◽

pp. 249-254

Author(s):

VINICIUS DE MELDAU BENITES ◽

FABIO VEIGA DE CASTRO SPARAPANI ◽

EDUARDO AUGUSTO IUNES ◽

FRANZ JOOJI ONISHI ◽

THIAGO SALATI ◽

...

Keyword(s):

Systematic Review ◽

Minimally Invasive ◽

Case Reports ◽

Surgical Techniques ◽

Case Series ◽

Pedicle Screws ◽

Invasive Procedure ◽

Cochrane Library ◽

Disc Disease ◽

Level Of Evidence

ABSTRACT A systematic review of the literature was performed in order to organize, evaluate, and select evidences available about the safety and efficacy of minimally invasive percutaneous arthrodesis with percutaneous pedicle screws in the treatment of patients with degenerative disc disease (and other spinal pathologies) as compared to conventional arthrodesis. PubMed, EMBASE and Cochrane Library databases were consulted to locate clinical trials and case reports/case series published in English between 2014 and 2019. After selection according to the inclusion/exclusion criteria, 21 of the 197 articles identified were chosen for a complete reading and used for the present review. Although the level of evidence of most of the studies included made the demonstration of efficacy and superiority among the surgical techniques reviewed difficult, the findings related to the minimally invasive procedure indicate a safe and reliable approach for the treatment of lumbar diseases. Level of evidence II; Systematic review of literature.

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