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

scholarly journals Treatment of Idiopathic Granulomatous Mastitis: Combined Intralesional Steroid Injection with Topical Steroid Administration vs. Systemic (Oral) Steroid

2021 ◽  
Author(s):  
Osman toktas ◽  
Nursen Toprak ◽  
Sadi Elasan ◽  
Iskan Calli ◽  
Serhat Binici
Keyword(s):  
Treatment Group ◽  
Side Effects ◽  
Steroid Injection ◽  
Corticosteroid Treatment ◽  
Oral Steroid ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Caseating Granuloma ◽  
Intralesional Steroid ◽  
Intralesional Steroid Injection

Abstract BackgroundIdiopathic granulomatous mastitis (IGM)is characterized by non-caseating granuloma and microabscess formation limited to mammary gland lobules. It is a form of chronic mastitis of unknown pathogenesis. In this study, we aimed to compare the effectiveness of intralesional steroid injection with topical steroids versus systemic steroid therapy in the treatment of IGM. MethodsBetween June 2017 and December 2020, the patients were collected and assessed. IGM was diagnosed histopathologically by tru-cut biopsy in patients with breast mass, pain, and erythema with suspicion of IGM. Included in the study were one hundred and eleven patients who were diagnosed with IGMand who were treated with local or oral administration of corticosteroids, with at least 6 months of follow-up. The patients were divided into 2 groups: a local corticosteroid treatment group (LC, group 1, n=57); and a peroral corticosteroid treatment group (OC, group 2, n=54). Demographic characteristics, treatment responses, recurrence rates, side effects of the steroid, and the need for surgery were compared.ResultsWhile the rate of smoking was 12.3% in the LC group, was 20.4% in the OC group. There was no history of oral contraceptive use in either group of patients. Previous steroid use was significantly lower in the LC group (10.5%) compared to the OC group (55.6%) (p = 0.001). Previous antibiotic use was significantly lower in the LC group (75.4%) compared to the OC group (100%) (p = 0.001). When complete and partial responders were grouped as “responders,” 96.5% in the LC group and 75.9% in the OC group responded after the first course of treatment (p=0.001). 98.2% in the LC group and 87.0% in the OC group were complete responders after the third course of treatment (p=0.003). While 7% of the patients in the LC group had recurrence, 37% in the OC group had recurrence (p=0.001). Steroid-related side effects were lower in the LC group (no) compared to the OC group (11.1%) (p=0.010). Surgery was performed in 3.5% of the LC group, while surgery was performed in 57.3% of the OC group (p=0.001). ConclusionSteroid injection is an IGM treatment with proven efficacy, short response time, low recurrence rate, and lower need surgery. The treatment is easy to administer and minimizes the risk of systemic side effects. Even in clinically severe cases, we believe that steroid injection might be used as monotherapy, or in combination with other therapies, to improve treatment efficacy and create a transition to less aggressive treatments.

PS02.208: THE SHIELDING METHOD WITH POLYGLYCOLIC ACID SHEETS AND FIBRIN GLUE FOR PREVENTING ESOPHAGEAL STRICTURE AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION: A HISTORICAL CONTROL STUDY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 181-181
Author(s):  
Toshiro Iizuka ◽  
Daisuke Kikuchi ◽  
Yugo Suzuki ◽  
Shu Hoteya
Keyword(s):  
Fibrin Glue ◽  
Esophageal Stricture ◽  
Steroid Injection ◽  
Polyglycolic Acid ◽  
Control Group ◽  
Study Group ◽  
Group 4 ◽  
Stricture Rate ◽  
Intralesional Steroid ◽  
Intralesional Steroid Injection

Abstract Background There have been several reports that steroid administration are effective at preventing strictures after ESD. However, adverse events after steroid use are of great concern. We have reported that shielding with polyglycolic acid (PGA) sheets and fibrin glue can be useful for prevention of stricture after ESD. We conducted a retrospective analysis of efficiency of shielding with PGA sheets and fibrin glue for prevention of esophageal stricture compared with intralesional steroid injection. Methods ESD was performed on a total of 608 lesions in 553 patients for superficial esophageal cancer from January 2012 to March 2017. Of these, 45 lesions were enrolled in the study group (PGA sheets and fibrin glue) and 40 lesions were enrolled in the control group (intralesional steroid injection). The incidence of postoperative stricture at 6 weeks and the number of sessions of endoscopic balloon dilatation (EBD) required to resolve any strictures were evaluated. Among them, patients with additional surgery were excluded in both groups when investing the outcome. Results The post-ESD stricture rate was 10.5% in the study group (4/38 patients), which was not significantly lower than the stricture rate of 10.8% in the historical control group (4/37 patients; P = 0.63). The mean number of EBD was 1.2 ± 4.2 in the study group and 0.68 ± 2.2 in the control group, which was not significant (P = 0.47). Conclusion PGA sheets and fibrin glue appear to be a promising option for the prevention of esophageal stricture similar to the effect of intralesional steroid injection. Disclosure All authors have declared no conflicts of interest.

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