Tacrolimus 0.03% ointment for treatment of paediatric lichen sclerosus: a case series and literature review

Objectives This study aimed to investigate the usefulness and tolerability of topical tacrolimus in paediatric vulvar lichen sclerosus (LS). We examined whether there was improvement of the most problematic symptoms, such as itching, pain, and vulvar constipation. Methods Ten girls, aged from 4 to 9 years old who were affected by vulvar LS, were enrolled in an open clinical study to confirm the efficacy of tacrolimus 0.03% ointment to treat LS. Tacrolimus was applied twice a day for 6 weeks and then stopped during the follow-up period. The study duration included 6 weeks of treatment and 6 weeks of follow-up. A literature search of the PubMed (MEDLINE) database was conducted of reports published since 1 January, 2004. Results Our study and previous studies indicated the potential effectiveness of tacrolimus in LS. Treatment with topical tacrolimus was well tolerated with significant improvement of itching, pain, and constipation. Conclusion Tacrolimus may be a safe and effective alternative treatment, without the risk of corticosteroid-related vulvar atrophy, for paediatric vulvar LS. LS could become a further indication of topical tacrolimus therapy if these promising results are confirmed in the future.

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Sinus Floor Augmentation—Associated Surgical Ciliated Cysts: Case Series and a Systematic Review of the Literature

Applied Sciences ◽

10.3390/app11041903 ◽

2021 ◽

Vol 11 (4) ◽

pp. 1903

Author(s):

Adrian Kahn ◽

Shlomo Matalon ◽

Rahaf Bassam Salem ◽

Lazar Kats ◽

Liat Chaushu ◽

...

Keyword(s):

Systematic Review ◽

Microscopic Examination ◽

Literature Search ◽

Case Series ◽

Systematic Literature Search ◽

Review Of The Literature ◽

Inclusion Criteria ◽

Sinus Floor Augmentation ◽

Sinus Floor

This study aimed to characterize the demographic and clinical features of underreported surgical ciliated cysts developing after sinus floor augmentation, based on a series of cases from our files and a systematic review of the literature. A series of five cases (four patients) of microscopically confirmed surgical ciliated cysts following sinus floor augmentation procedures from our files are described. A systematic literature search (1991–2020) with strict clinical-, radiological- and microscopic-based exclusion and inclusion criteria was performed to detect additional similar cases. The systematic review revealed only five cases that fulfilled the inclusion criteria. Altogether, surgical ciliated cysts associated with sinus floor augmentation have been rarely reported in the literature, and have not been characterized either demographically or clinically. Graft materials were diverse, implants were placed simultaneously, or up to two years post-augmentation. The associated surgical ciliated cysts developed between 0.5 and 10 years post-augmentation. Although limited in its extent, this study is the first series to characterize possible underreported sequelae of surgical ciliated cysts associated with sinus floor augmentation. It emphasizes the need for long post-operative follow-up and confirmation of lesion by microscopic examination.

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Long-term outcomes of acromegaly treated with fractionated stereotactic radiation: case series and literature review

Neuro-Oncology Practice ◽

10.1093/nop/npx002 ◽

2017 ◽

Vol 4 (4) ◽

pp. 255-262

Author(s):

Ryan Rhome ◽

Isabelle M Germano ◽

Ren-Dih Sheu ◽

Sheryl Green

Keyword(s):

Systematic Review ◽

Literature Review ◽

Case Series ◽

Tumor Control ◽

Pituitary Neoplasms ◽

Review Of The Literature ◽

Biochemical Control ◽

Low Incidence

Abstract Background Growth hormone (GH)-secreting pituitary adenomas represent an uncommon subset of pituitary neoplasms. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) have been used as primary or adjuvant treatment. The purpose of this study is to report the long-term tumor control and toxicity from our institution and to perform a systematic literature review of acromegaly patients treated with FSRT. Methods We retrospectively reviewed all patients treated with FSRT (median dose 50.4 Gray [Gy], range 50.4–54 Gy) between 2005 and 2012 who had: 1) GH-secreting adenoma with persistently elevated insulin growth factor-1 (IGF-1) despite medical therapy and 2) clinical follow up >3 years after FSRT. Patients were treated with modern FSRT planning techniques. Biochemical control was defined as IGF-1 normalization. Systematic review of the literature was performed for FSRT in acromegaly. Results With a median follow-up of 80 months, radiographic control was achieved in all 11 patients and overall survival was 100%. Long-term biochemical control was achieved in 10 patients (90.9%) with either FSRT alone (36.4%) or FSRT with continued medical management (45.5%). No patient experienced new hypopituitarism, cranial nerve dysfunctions, or visual deficits. Our systematic review found published rates of biochemical control and hypopituitarism vary, with uniformly good radiographic control and low incidence of visual changes. Conclusions Adjuvant FSRT offered effective long-term biochemical control and radiographic control, and there was a lower rate of complications in this current series. Review of the literature shows variations in published rates of biochemical control after FSRT for acromegaly, but low incidence of serious toxicities.

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Case Series Regarding Parastomal Variceal Bleeding: Presentation and Management

Annals of Hepatology ◽

10.5604/01.3001.0012.2228 ◽

2018 ◽

Vol 17 (5) ◽

pp. 0-10

Author(s):

John Romano ◽

Charles V. Welden ◽

Jordan Orr ◽

Brendan McGuire ◽

Mohamed Shoreibah

Keyword(s):

Portal Hypertension ◽

High Risk ◽

Literature Review ◽

Variceal Bleeding ◽

Coil Embolization ◽

Case Series ◽

Treatment Modalities ◽

Post Procedure ◽

Lost To Follow Up

Parastomal variceal bleeding (PVB) is a serious complication occurring in up to 27% of patients with an ostomy and concurrent cirrhosis and portal hypertension. The management of PVB is difficult and there are no clear guidelines on this matter. TIPS, sclerotherapy, and /or coil embolization are all therapies that have been shown to successful manage PVB. We present a case series with five different patients who had a PVB at our institution. The aim of this case series is to report our experience on the management of this infrequently reported but serious condition. We also conducted a systemic literature review focusing on the treatment modalities of 163 patients with parastomal variceal bleeds. In our series, patient 1 had embolization and sclerotherapy without control of bleed and expired on the day of intervention due to hemorrhagic shock. Patient 2 had TIPS in conjunction with embolization and sclerotherapy and had no instance of rebleed 441 days after therapy. Patient 3 did not undergo any intervention due to high risk for morbidity and mortality, the bleed self-resolved and there was no further rebleed, this same patient died of sepsis 73 days later. Patient 4 had embolization and sclerotherapy and had no instance of rebleed 290 days after therapy. Patient 5 had TIPS procedure and was discharged five days post procedure without rebleed, patient has since been lost to follow-up.

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Synovial fluid eosinophilia: a case series with a long follow-up and literature review

Rheumatology ◽

10.1093/rheumatology/kes236 ◽

2012 ◽

Vol 52 (2) ◽

pp. 346-351 ◽

Cited By ~ 5

Author(s):

C. Vazquez-Trinanes ◽

B. Sopena ◽

L. Gonzalez-Gonzalez ◽

R. Diaz ◽

A. Rivera ◽

...

Keyword(s):

Synovial Fluid ◽

Literature Review ◽

Case Series

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Nonablative radiofrequency in the treatment of refractory vulvar lichen sclerosus: A case series

JAAD Case Reports ◽

10.1016/j.jdcr.2021.09.028 ◽

2021 ◽

Author(s):

Rodrigo Rossi Balbinotti ◽

Fernanda Santos Grossi ◽

Amanda Vilaverde Perez ◽

Mariana Sbaraini ◽

Luciana Borges Chagas ◽

...

Keyword(s):

Case Series ◽

Lichen Sclerosus ◽

Vulvar Lichen Sclerosus

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Vulvar Lichen Sclerosus et Atrophicus in girls

Российский педиатрический журнал ◽

10.46563/1560-9561-2021-24-5-356-360 ◽

2021 ◽

Vol 24 (5) ◽

pp. 356-360

Author(s):

Leila V. Adamyan ◽

Sergey M. Sharkov ◽

Elena V. Sibirskaya ◽

Laura G. Pivazyan ◽

Julietta S. Avetisyan

Keyword(s):

Randomized Clinical Trials ◽

Clinical Symptoms ◽

Case Series ◽

Lichen Sclerosus ◽

Genetic Mutations ◽

Lichen Sclerosus Et Atrophicus ◽

Inflammatory Dermatosis ◽

Anogenital Region ◽

Literature Reviews ◽

Vulvar Lichen Sclerosus

The review is devoted to diagnosing and treating lichen sclerosus (LS), a chronic inflammatory dermatosis with a predisposition to lesions of the anogenital region in girls. An essential role in the aetiology of this form of pathology is attributed to genetic mutations, injuries, infections and autoimmune diseases, and hormonal and local factors. The peak incidence is observed in 4-6 year girls, accounting for 7-15% of all cases of vulvar LS. The main goal of pharmacotherapy for vulvar LS is to relieve clinical symptoms and prevent scarring and adhesions. The authors analyzed international and domestic publications from 2017 to 2021. PubMed and Google Academy databases were used for the search, keywords: lichen sclerosus, girls. The retrospective and prospective cohort, randomized clinical trials, case series and literature reviews, and clinical guidelines were considered. Our review presents modern data on the diagnosis and treatment of SL in girls, which will be useful for both pediatric gynecologists and doctors of related specialties. The first symptoms of LS are usually nonspecific and are misdiagnosed by non-profile specialists. Some symptoms of LS may disappear spontaneously after menarche, and the course of the disease may be latent. This is why it is generally accepted that the epidemiology of LS is underestimated. Despite this, it can be assumed that the etiology and pathogenesis of LS is probably multifactorial. This review describes several leading etiological factors regarding the potential etiopathogenesis of vulvar LS in girls.

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Myasthenia Gravis Exacerbation and Myasthenic Crisis Associated With COVID19: Case Series and Literature Review.

10.21203/rs.3.rs-790941/v1 ◽

2021 ◽

Author(s):

Cleonisio Leite Rodrigues ◽

Hermany Capistrano Freitas ◽

Paulo Reges Oliveira Lima ◽

Pedro Helder de Oliveira Junior ◽

José Marcelino Aragão Fernandes ◽

...

Keyword(s):

Literature Review ◽

Neuromuscular Junction ◽

Hospital Mortality ◽

Myasthenia Gravis ◽

Viral Infections ◽

Case Series ◽

Previous Treatment ◽

Autoimmune Disorder ◽

Myasthenic Crisis

Abstract Myasthenia Gravis (MG) is an autoimmune disorder of the neuromuscular junction that can be exacerbated by many viral infections, including COVID19. Management of MG exacerbations is challenging in this scenario. We report 8 cases of MG exacerbation or myasthenic crisis associated with COVID19 and discuss prognosis and treatment based on a literature review. Most patients were female (7/8), with an average age of 47.1 years. Treatment was immunoglobulin (IVIG) in 3 patients, plasma exchange (PLEX) in 2 patients, and adjustment of baseline drugs in 3. In-hospital mortality was 25% and 37.5% in 2-month follow-up. This is the largest case series of MG exacerbation or myasthenic crisis due to COVID19 to this date. Mortality was considerably higher than in myasthenic crisis of other etiologies. Previous treatment for MG or acute exacerbation treatment did not seem to interfere with prognosis, although sample size was too small to draw definitive conclusions. Further studies are needed to understand the safety and effectiveness of interventions in this setting, particularly of PLEX, IVIG, rituximab and tocilizumab.

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