Surgical Answer to Intralesional Steroid–Induced Skin Atrophy

2017 ◽  
Vol 43 (4) ◽  
pp. 591-592 ◽  
Author(s):  
Karalikkattil T. Ashique ◽  
Feroze Kaliyadan
Keyword(s):  
Skin Atrophy ◽  
Intralesional Steroid

Kindler's Syndrome with Recurrent Neutropenia: Report of Two Cases from Saudi Arabia

2020 ◽  
Author(s):  
Yousef Binamer ◽  
Muzamil A. Chisti
Keyword(s):  
Autosomal Recessive ◽  
Common Mechanism ◽  
Sequencing Analysis ◽  
Loss Of Function ◽  
Skin Atrophy ◽  
Whole Exome ◽  
Infancy And Childhood ◽  
Genetics And Genomics ◽  
New Feature ◽  
Generation Sequencing

AbstractKindler syndrome (KS) is a rare photosensitivity disorder with autosomal recessive mode of inheritance. It is characterized by acral blistering in infancy and childhood, progressive poikiloderma, skin atrophy, abnormal photosensitivity, and gingival fragility. Besides these major features, many minor presentations have also been reported in the literature. We are reporting two cases with atypical features of the syndrome and a new feature of recurrent neutropenia. Whole exome sequencing analysis was done using next-generation sequencing which detected a homozygous loss-of-function (LOF) variant of FERMT1 in both patients. The variant is classified as a pathogenic variant as per the American College of Medical Genetics and Genomics guidelines. Homozygous LOF variants of FERMT1 are a common mechanism of KS and as such confirm the diagnosis of KS in our patients even though the presentation was atypical.

scholarly journals Life-Threatening Subglottic Stenosis of Granulomatosis with Polyangiitis: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 423
Author(s):  
Jin An ◽  
Jae-Won Song
Keyword(s):  
Immunosuppressive Therapy ◽  
Granulomatosis With Polyangiitis ◽  
Granulomatous Inflammation ◽  
Subglottic Stenosis ◽  
Emergency Tracheostomy ◽  
Intralesional Steroid ◽  
Intralesional Steroid Injection ◽  
Life Threatening ◽  
Carbon Dioxide Co2 ◽  
Laryngotracheal Resection

Granulomatosis with polyangiitis (GPA) is an autoimmune disease characterized by necrotizing granulomatous inflammation. Subglottic stenosis, which is defined as narrowing of the airway below the vocal cords, has a frequency of 16–23% in GPA. Herein, we present the case of a 39-year-old woman with subglottic stenosis manifesting as life-threatening GPA, which was recurrent under systemic immunosuppressive therapy. The patient underwent an emergency tracheostomy, intratracheal intervention, such as carbon dioxide (CO2) laser surgery and intralesional steroid injection via laryngomicroscopic surgery, and laryngotracheal resection with remodeling. Severe subglottic stenosis treatment requires active intratracheal intervention, surgery, and systemic immunosuppressive therapy.

The Efficacy of Skin Cooling for Pain Relief during Intralesional Steroid Injection for Keloid Treatment: A Randomized Cross-Over Study

2021 ◽  
Vol 104 (11) ◽  
pp. 1752-1757
Keyword(s):  
Treatment Group ◽  
Rating Scale ◽  
Steroid Injection ◽  
Pairwise Comparison ◽  
Random Order ◽  
Repeated Measure ◽  
Skin Cooling ◽  
Intralesional Steroid ◽  
Intralesional Steroid Injection ◽  
Pre Treatment

Objective: To evaluate if pre-treatment skin cooling can reduce the pain during steroid injection. Materials and Methods: A randomized cross-over study was conducted between September 2015 and October 2016. This study received ethical approval ID035904 No. MURA2016/152. Forty-four subjects with keloid that needed intralesional steroid injection were divided into three pretreatment groups, no treatment, skin cooling with ice pack, and skin applying with a mixture of lidocaine 2.5% and prilocaine 2.5% (EMLA®), in random order. Pain intensity was measured by using 100-mm visual analogue scale (VAS). The satisfaction levels were assessed with orderly interval rating scale from 1 to 5. Repeated-measure analysis of variance (ANOVA) and Bonferroni pairwise comparison were used for data analyses. Results: The mean VAS score at the time of needle puncturing into the skin and during steroid infiltration was statistically significant lower in skin cooling compared to no treatment group (p<0.001) and EMLA group (p<0.05). The satisfaction level was also statistically significant higher in skin cooling compared to no treatment group (p<0.001) and EMLA group (p<0.001). Thirty-seven patients (84%) selected skin cooling method as the most favorable pre-anesthetic method for intralesional steroid injection. Conclusion: Skin cooling with ice before intralesional steroid injection of keloid effectively reduces pain and patients are also satisfied. Keyword: Keloid, Corticosteroid, Pre-treatment, pain, skin cooling

Less is more when treating the nasal ala with superficial radiotherapy

2020 ◽  
Vol 7 (3) ◽  
pp. 66-69
Author(s):  
Lucy M Butcher ◽  
Gerald B Fogarty ◽  
Susan Sinclair ◽  
Hanna Kuchel ◽  
Robert Paver
Keyword(s):  
Functional Outcomes ◽  
Skin Atrophy ◽  
Functional Importance ◽  
Less Is More ◽  
Skin Cancers ◽  
Nasal Ala ◽  
Cosmetic Outcomes ◽  
Standard Fractionation ◽  
Comparative Trials ◽  
Common Malignancy

Skin cancer is the most common malignancy, is increasing in incidence, and occurs most commonly on the head and neck. Cancers of the nasal ala pose therapeutic challenges given the cosmetic and functional importance. Both surgery and radiotherapy (RT) have similar oncological outcomes. RT is tissue-conserving and may have an advantage in cosmetic and functional outcomes, but more comparative trials are needed. RT needs to be delivered well to avoid late effects such as skin atrophy, fibrosis and telangiectasia, which may increase with higher dose per fraction. We describe three cases of self-reported thinning of the nasal ala following definitive mildly hypofractionated superficial radiotherapy (SXRT) of 2.5 Gy per fraction. SXRT to skin cancers of the nasal alar with standard fractionation of at most 2 Gy per fraction may be important in ensuring excellent cosmetic outcomes and patient satisfaction.

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