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Wang J, Chen Z, Zhou C, Yu B. Clinical efficacy of intense pulsed light combined with low-dose intralesional corticosteroids in treating noninfectious granulomas after mesotherapy: A case series analysis. J Cosmet Dermatol 2024; 23:1669-1676. [PMID: 38351623 DOI: 10.1111/jocd.16213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/10/2024] [Accepted: 01/23/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Mesotherapy is a popular cosmetic procedure for localized delivery of substances. However, due to the lack of standardized processes, there are potential risks of adverse reactions. Granulomas formation is one of the chronic reactions which impose significant physical and mental burdens on patients. OBJECTIVES The aim of this analysis is to evaluate the safety and feasibility of combining intense pulsed light (IPL) with intralesional corticosteroids for treating noninfectious granulomas after mesotherapy. METHODS This retrospective observational case series included patients who suffer from noninfectious granulomas after mesotherapy and received combination of IPL and intralesional corticosteroids treatment between October 2021 and December 2022 at Peking University Shenzhen Hospital, Shenzhen, China. The process and effect were analyzed and summarized. RESULTS Among the seven patients, five expressed extreme satisfaction with the efficacy, while two was slightly satisfied. The physicians believed that all patients had shown significant improvement. No adverse reactions or recurrences were observed during follow-up. CONCLUSION Based on this analysis, the application of the combined treatment in patients suffering from noninfectious granuloma due to mesotherapy demonstrates good clinical efficacy and safety, making it worth considering as a treatment option.
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Affiliation(s)
- Jieyi Wang
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, China
| | - Zhuoxuan Chen
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, China
| | - Cheng Zhou
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, China
- Department of Medicine, Shenzhen University, Shenzhen, China
| | - Bo Yu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, China
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Schneider D, O'Leary M, Amini E, Miller J, Hassas N, Nguyen J, Hammad MAM, Barham D, Yafi FA. Peyronie's disease response to intralesional collagenase clostridium histolyticum therapy is independent of baseline testosterone. Andrology 2024; 12:830-834. [PMID: 37753943 DOI: 10.1111/andr.13532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 08/05/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Testosterone plays an important role in collagen metabolism, transforming growth factor-β1 expression, and wound healing, which are all critical factors in pathogenesis of Peyronie's disease. Some clinical studies have suggested an association between Peyronie's disease and hypogonadism. OBJECTIVE We sought to investigate whether baseline total testosterone levels influence response to intralesional collagenase clostridium histolyticum in Peyronie's disease. METHODS A retrospective review of patients receiving collagenase clostridium histolyticum injections with available total testosterone levels within 1 year of initial injection was conducted at a single institution. Baseline demographics, hypogonadal status, total testosterone, number of collagenase clostridium histolyticum cycles, and pre- and post-treatment degrees of curvature were collected. Hypogonadism was defined as total testosterone <300 ng/dL. RESULTS AND DISCUSSION Thirty-six men were included with mean age of 58.2 years (SD 10.4) and mean body mass index 26.8 (SD 3.2). The mean total testosterone was 459.2 ng/dL (SD 144.0), and four (11.1%) were hypogonadal. Mean pre-treatment curvature was 47.6°, and mean post-treatment curvature was 27.8°, with mean improvement of 19.9° (40.1%). Hypogonadal status was not significantly associated with more severe curvature, 46.4° among hypogonadal men as to 57.5° among eugonadal men (p = 0.32). On linear regression analysis, total testosterone did not significantly predict improvement in degrees (β = -0.02; R2 = 0.06; p = 0.14) or percent (β = 0.0; R2 = 0.05; p = 0.18). Improvement in neither degrees nor percent differed significantly by hypogonadal status (p = 0.41 and 0.82, respectively). The cycle number did significantly predict greater improvement in curvature on both univariate and multivariate analyses (β = 5.7; R2 = 0.34; p < 0.01). CONCLUSION Neither total testosterone nor hypogonadism is associated with a degree of improvement after collagenase clostridium histolyticum treatment.
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Affiliation(s)
- Douglas Schneider
- Irvine Department of Urology, University of California, Irvine, California, USA
| | - Mitchell O'Leary
- Irvine Department of Urology, University of California, Irvine, California, USA
| | - Eliad Amini
- Irvine Department of Urology, University of California, Irvine, California, USA
| | - Jake Miller
- Irvine Department of Urology, University of California, Irvine, California, USA
| | - Nick Hassas
- Irvine Department of Urology, University of California, Irvine, California, USA
| | - Jeanie Nguyen
- Irvine Department of Urology, University of California, Irvine, California, USA
| | | | - David Barham
- Irvine Department of Urology, University of California, Irvine, California, USA
| | - Faysal A Yafi
- Irvine Department of Urology, University of California, Irvine, California, USA
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Desouky E, Levine LA. Letter: Comparison of Collagenase Clostridium histolyticum to Surgery for the Management of Peyronie's Disease: A Randomized Trial. J Urol 2024; 211:708-709. [PMID: 38382016 DOI: 10.1097/ju.0000000000003881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 01/26/2024] [Indexed: 02/23/2024]
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Trost L. Reply: Comparison of Collagenase Clostridium histolyticum to Surgery for the Management of Peyronie's Disease: A Randomized Trial. J Urol 2024; 211:710-712. [PMID: 38447151 DOI: 10.1097/ju.0000000000003896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Landon Trost
- Male Fertility and Peyronie's Clinic, Orem, Utah
- CURE PD, Orem, Utah
- Brigham Young University, Provo, Utah
- Mayo Clinic, Rochester, Minnesota
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5
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Tang Y, Wei J, Ge X, Yu C, Lu W, Qian Y, Yang H, Fu D, Fang Y, Zhou X, Wang Z, Xiao Q, Ding K. Intratumoral injection of interferon gamma promotes the efficacy of anti-PD1 treatment in colorectal cancer. Cancer Lett 2024; 588:216798. [PMID: 38467181 DOI: 10.1016/j.canlet.2024.216798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 02/21/2024] [Accepted: 03/05/2024] [Indexed: 03/13/2024]
Abstract
Immune checkpoint inhibitors (ICIs) offer new options for the treatment of patients with solid cancers worldwide. The majority of colorectal cancers (CRC) are proficient in mismatch-repair (pMMR) genes, harboring fewer tumor antigens and are insensitive to ICIs. These tumors are often found to be immune-deserted. We hypothesized that forcing immune cell infiltration into the tumor microenvironment followed by immune ignition by PD1 blockade may initiate a positive immune cycle that can boost antitumor immunity. Bioinformatics using a public database suggested that IFNγ was a key indicator of immune status and prognosis in CRC. Intratumoral administration of IFNγ increased immune cells infiltration into the tumor, but induced PD-L1 expression. A combined treatment strategy using IFNγ and anti-PD-1 antibody significantly increased T cell killing of tumor cells in vitro and showed synergistic inhibition of tumor growth in a mouse model of CRC. CyTOF found drastic changes in the immune microenvironment upon combined immunotherapy. Treatment with IFNγ and anti-PD1 antibody in CT26 tumors significantly increased infiltration of polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs). IFNγ had a more pronounced effect in decreasing intratumoral M2-like macrophages, while PD1 blockade increased the population of CD8+Ly6C + T cells in the tumor microenvironment, creating a more pro-inflammatory microenvironment. Additionally, PD1 induced increased expression of lymphocyte activating 3 (LAG3) in a significant fraction of CD8+ T cells and Treg cells, indicating potential drug resistance and feedback mechanisms. In conclusion, our work provides preclinical data for the Combined immunotherapy of CRC using intratumoral delivery of IFNγ and systemic anti-PD1 monoclonoal antibody.
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Affiliation(s)
- Yang Tang
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Jingsun Wei
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Xiaoxu Ge
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Chengxuan Yu
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Wei Lu
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Yucheng Qian
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Hang Yang
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Dongliang Fu
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Yimin Fang
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Xinyi Zhou
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Zhanhuai Wang
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Qian Xiao
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China
| | - Kefeng Ding
- Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China.
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Gomar C, Di Trani CA, Bella A, Arrizabalaga L, Gonzalez-Gomariz J, Fernandez-Sendin M, Alvarez M, Russo-Cabrera JS, Ardaiz N, Aranda F, Schippers T, Quintero M, Melero I, Orlinger KK, Lauterbach H, Berraondo P. Efficacy of LCMV-based cancer immunotherapies is unleashed by intratumoral injections of polyI:C. J Immunother Cancer 2024; 12:e008287. [PMID: 38631714 PMCID: PMC11029445 DOI: 10.1136/jitc-2023-008287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Lymphocytic choriomeningitis virus (LCMV) belongs to the Arenavirus family known for inducing strong cytotoxic T-cell responses in both mice and humans. LCMV has been engineered for the development of cancer immunotherapies, currently undergoing evaluation in phase I/II clinical trials. Initial findings have demonstrated safety and an exceptional ability to activate and expand tumor-specific T lymphocytes. Combination strategies to maximize the antitumor effectiveness of LCMV-based immunotherapies are being explored. METHODS We assessed the antitumor therapeutic effects of intratumoral administration of polyinosinic:polycytidylic acid (poly(I:C)) and systemic vaccination using an LCMV-vector expressing non-oncogenic versions of the E6 and E7 antigens of human papillomavirus 16 (artLCMV-E7E6) in a bilateral model engrafting TC-1/A9 cells. This cell line, derived from the parental TC-1, exhibits low MHC class I expression and is highly immune-resistant. The mechanisms underlying the combination's efficacy were investigated through bulk RNA-seq, flow cytometry analyses of the tumor microenvironment, selective depletions using antibodies and clodronate liposomes, Batf3 deficient mice, and in vivo bioluminescence experiments. Finally, we assessed the antitumor effectiveness of the combination of artLCMV-E7E6 with BO-112, a GMP-grade poly(I:C) formulated in polyethyleneimine, currently under evaluation in clinical trials. RESULTS Intratumoral injection of poly(I:C) enhanced the antitumor efficacy of artLCMV-E7E6 in both injected and non-injected tumor lesions. The combined treatment resulted in a significant delay in tumor growth and often complete eradication of several tumor lesions, leading to significantly improved survival compared with monotherapies. While intratumoral administration of poly(I:C) did not impact LCMV vector biodistribution or transgene expression, it significantly modified leucocyte infiltrates within the tumor microenvironment and amplified systemic efficacy through proinflammatory cytokines/chemokines such as CCL3, CCL5, CXCL10, TNF, IFNα, and IL12p70. Upregulation of MHC on tumor cells and a reconfiguration of the gene expression programs related to tumor vasculature, leucocyte migration, and the activation profile of tumor-infiltrating CD8+ T lymphocytes were observed. Indeed, the antitumor effect relied on the functions of CD8+ T lymphocytes and macrophages. The synergistic efficacy of the combination was further confirmed when BO-112 was included. CONCLUSION Intratumoral injection of poly(I:C) sensitizes MHClow tumors to the antitumor effects of artLCMV-E7E6, resulting in a potent therapeutic synergy.
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Affiliation(s)
- Celia Gomar
- Program of Immunology and Immunotherapy, Cima Universidad de Navarra, Pamplona, Spain
| | | | - Angela Bella
- Program of Immunology and Immunotherapy, Cima Universidad de Navarra, Pamplona, Spain
| | - Leire Arrizabalaga
- Program of Immunology and Immunotherapy, Cima Universidad de Navarra, Pamplona, Spain
| | - Jose Gonzalez-Gomariz
- Program of Immunology and Immunotherapy, Cima Universidad de Navarra, Pamplona, Spain
| | | | - Maite Alvarez
- Program of Immunology and Immunotherapy, Cima Universidad de Navarra, Pamplona, Spain
| | | | - Nuria Ardaiz
- Program of Immunology and Immunotherapy, Cima Universidad de Navarra, Pamplona, Spain
| | - Fernando Aranda
- Program of Immunology and Immunotherapy, Cima Universidad de Navarra, Pamplona, Spain
| | | | | | - Ignacio Melero
- Program of Immunology and Immunotherapy, Cima Universidad de Navarra, Pamplona, Spain
- Departments of Immunology and Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | | | | | - Pedro Berraondo
- Program of Immunology and Immunotherapy, Cima Universidad de Navarra, Pamplona, Spain
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Loloi J, Schuppe K, Reddy RV, Rahman F, Bernstein A, Reddy P, Kulkarni N, Masterson T, Ramasamy R. A survey of exposure to the use of Xiaflex for the treatment of Peyronie's disease among United States urology residency programs. Int J Impot Res 2024; 36:155-159. [PMID: 37865716 DOI: 10.1038/s41443-023-00781-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 10/23/2023]
Abstract
Xiaflex® (collagenase clostridium histolyticum) is a Food and Drug Administration-approved treatment for patients with Peyronie's disease. Despite its approval and implementation, there is concern that urologists in training are offered minimal exposure to its use. Thus, the purpose of this study was to evaluate the exposure of urology residents to Peyronie's disease and its management, particularly Xiaflex®. A Google Forms survey regarding the exposure of residents to Peyronie's disease and use of Xiaflex® was created and disseminated through email to urology programs. Overall, 47 institutional responses were received. At 45 institutions (95.7%), residents receive training in directly evaluating and caring for patients with Peyronie's disease. At 46 institutions (97.9%), residents receive training in observing and/or performing surgical procedures for Peyronie's disease. Residents at 31 institutions (66.0%) receive observational or procedural training for non-surgical management of Peyronie's disease, specifically Xiaflex®. Residents receive non-surgical training from an academic faculty who is fellowship trained in sexual medicine at 25 institutions and an academic faculty not trained in sexual medicine at six institutions. There exists a glaring disparity in residency exposure to Xiaflex®. Further research is warranted to elucidate how programs can provide residents with further exposure to the use of Xiaflex® in patients with Peyronie's disease.
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Affiliation(s)
- Justin Loloi
- Department of Urology, Montefiore Medical Center, Bronx, NY, USA.
| | - Kyle Schuppe
- Washington State University Elson S. Floyd College of Medicine, Spokane, WA, USA
| | - Raghuram V Reddy
- Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Farah Rahman
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ari Bernstein
- Department of Urology, New York University Langone Health, New York, NY, USA
| | - Pritika Reddy
- Alabama College of Osteopathic Medicine, Dothan, AL, USA
| | - Nikhil Kulkarni
- Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Thomas Masterson
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Roadman D, Wang V, Beer A, Levine L. A contemporary assessment of the evaluation and management of patients presenting to a tertiary medical center with Peyronie's disease. Int J Impot Res 2024; 36:118-124. [PMID: 37468535 DOI: 10.1038/s41443-023-00738-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
Peyronie's disease continues to be poorly understood. We characterize the presenting features of Peyronie's disease within a large cohort and elucidate the factors that correlate with surgical intervention. Univariate and multivariate analyses were performed on 1483 consecutive patients to assess pre-operative predictors of surgical intervention for Peyronie's disease. Overall, 1263 patients met inclusion criteria. Mean age was 55.4 ± 11.1 years with a mean duration of disease at presentation of 33.2 ± 42.5 months. Mean primary curvature was 49.8 ± 20.8°. Primary ventral curvature was present in 11.4% and 36.5% of patient had a multiplanar curvature. During penile duplex ultrasound evaluation indentation/narrowing deformities were appreciated in 76.0%, hourglass deformity in 10.1%, and hinge effect in 33.0% of patients. Calcification was seen in 30.1% of patients. Operative intervention occurred in 35.3% of patients. Degree of primary curvature (1.03 OR, p < 0.001), hourglass deformity (1.82 OR, p = 0.01), decreased tunical elasticity (1.20 OR, p = 0.03), and prior intralesional collagenase clostridium histolyticum injections (2.94 OR, p < 0.001) predicted surgical correction on multivariate analysis. Compared to historical studies, we found a higher incidence of severe degree of curvature (27.5% >60°), indentation deformities, hinge-effect, multiplanar curvature and penile calcifications. Ultimately, predictors of surgical intervention included those with worse erectile function and more severe characteristics.
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Affiliation(s)
- Daniel Roadman
- Rush University Medical Center Department of Urology, 1725 West Harrison Street, Chicago, IL, 60612, USA
| | - Vinson Wang
- The Urology Group, 2000 Joseph E Sanker Blvd, Cincinnati, OH, 45212, USA
| | - Adam Beer
- Buffalo General Medical Center, 100 High Street Buffalo, Buffalo, NY, 14203, USA
| | - Laurence Levine
- Rush University Medical Center Department of Urology, 1725 West Harrison Street, Chicago, IL, 60612, USA.
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Gray KM, Khatiwada P, Capito AE. Industry Sponsorship Bias in Collagenase Clinical Trials for Dupuytren Disease: A Meta-analysis. Ann Plast Surg 2024; 92:389-394. [PMID: 38527344 DOI: 10.1097/sap.0000000000003831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
BACKGROUND Collagenase clostridium histolyticum (collagenase) was introduced in 2010 creating a nonoperative treatment option for Dupuytren disease with promising results in sponsored clinical trials. A meta-analysis was performed to investigate industry sponsorship bias. METHODS A systematic review of collagenase treatment of Dupuytren contracture was conducted. Articles containing mesh terms including "microbial collagenase" and "Dupuytren's contracture" were searched and limited to only clinical trials with similar protocols for inclusion. Meta-analysis of treatment endpoints of correction of contracture to 0-5 degrees after first and last injection was conducted comparing sponsored versus nonsponsored studies. RESULTS Sixteen of the 29 identified articles met criteria for inclusion. Nonsponsored studies reported a significantly higher rate of meeting the primary treatment endpoint compared to sponsored studies after single injection for all joints (69.6% vs 56% P < 0.01), metacarpophalangeal joint (96% vs 64% P < 0.01), and proximal interphalangeal joint (67% vs 36% P = 0.011). The correction in contracture rates was similar between groups with studies evaluating more than one injection. CONCLUSIONS Nonsponsored studies published higher success rates in meeting the primary endpoint of full correction after single injection than sponsored studies; however, similar results with multiple injections. This study demonstrated that sponsored studies of collagenase produced highly powered studies that may be reliably depended on for evidence-based clinical application.
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Zugail AS, Alshuaibi M, Lombion S, Beley S. Safety and feasibility of percutaneous needle tunneling with platelet-rich plasma injections for Peyronie's disease in the outpatient setting: a pilot study. Int J Impot Res 2024; 36:140-145. [PMID: 37550385 DOI: 10.1038/s41443-023-00744-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 08/09/2023]
Abstract
The objective of this study is to evaluate the safety and feasibility of the combined simultaneous percutaneous needle tunneling coupled with injection of platelet-rich plasma in the outpatient department for the treatment of Peyronie's disease. This prospective, non-randomized, cohort and preliminary study included patients who underwent this procedure from November 2020 to July 2022. The main outcome was an improvement in penile curvature. Fifty-four patients were enrolled and underwent 6 sessions under local anesthesia followed by vacuum therapy for the treatment of Peyronie's disease in our outpatient unit. The amendment of the curvature angle was significant with a median correction percentage of -44.40% interquartile range (-66.70 to (-39.70)), [p-value = 0.001, 95% CI (-29.76 to (-18.02)), paired Student's t-test]. The median pre-treatment curvature angle was 45° (40-75), and the median post-treatment was 30° (20-40). The median score for pain during the procedure was 3 (0-4.25) according to a 10-point visual analogic scale. After two hours, 20.37% of patients still had pain but none required any pain medication. 50% of patients had a minor hematoma and 75.93% patients reported penile ecchymosis. A single patient reported an injection site skin infection. In our experience percutaneous needle tunneling with platelet-rich plasma injections for Peyronie's disease in the outpatient setting is a safe, effective, and feasible treatment of penile deformity for PD.
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Affiliation(s)
- Ahmed S Zugail
- Department of Urology, Clinique Turin, Groupe Almaviva Santé, Paris, France.
- Urology Division, Department of Surgery, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Muaath Alshuaibi
- Department of Urology, Clinique Turin, Groupe Almaviva Santé, Paris, France
- Department of Urology, Faculty of Medicine, University of Ha'il, Ha'il, Saudi Arabia
| | | | - Sébastien Beley
- Department of Urology, Clinique Turin, Groupe Almaviva Santé, Paris, France
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11
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Ricardo JW, Qiu Y, Lipner SR. Optimizing intralesional triamcinolone acetonide treatment for isolated nail psoriasis: a pilot, intra-subject randomized controlled trial. Arch Dermatol Res 2024; 316:113. [PMID: 38526737 DOI: 10.1007/s00403-024-02849-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 03/27/2024]
Affiliation(s)
- Jose W Ricardo
- Department of Dermatology, Weill Cornell Medicine, New York, NY, United States
| | - Yuqing Qiu
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, NY, United States.
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12
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Aragón-Franco R, Ruiz-Manzano RA, Nava-Castro KE, Del Rìo Araiza VH, Garay-Canales CA, Pérez-Torres A, Chacón-Salinas R, Girón-Pérez MI, Morales-Montor J. Convergence between helminths and breast cancer: intratumoral injection of the excretory/secretory antigens of the human parasite Toxocara canis (EST) increase lung macro and micro metastasis. Front Immunol 2024; 15:1332933. [PMID: 38576624 PMCID: PMC10993691 DOI: 10.3389/fimmu.2024.1332933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/21/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Worldwide, breast cancer is the most important cancer in incidence and prevalence in women. Different risk factors interact to increase the probability of developing it. Biological agents such as helminth parasites, particularly their excretory/secretory antigens, may play a significant role in tumor development. Helminths and their antigens have been recognized as inducers or promoters of cancer due to their ability to regulate the host's immune response. Previously in our laboratory, we demonstrated that chronic infection by Toxocara canis increases the size of mammary tumors, affecting the systemic response to the parasite. However, the parasite does not invade the tumor, and we decided to study if the excretion/secretion of antigens from Toxocara canis (EST) can affect the progression of mammary tumors or the pathophysiology of cancer which is metastasis. Thus, this study aimed to determine whether excretion/secretion T. canis antigens, injected directly into the tumor, affect tumor growth and metastasis. Methods We evaluated these parameters through the monitoring of the intra-tumoral immune response. Results Mice injected intratumorally with EST did not show changes in the size and weight of the tumors; although the tumors showed an increased microvasculature, they did develop increased micro and macro-metastasis in the lung. The analysis of the immune tumor microenvironment revealed that EST antigens did not modulate the proportion of immune cells in the tumor, spleen, or peripheral lymph nodes. Macroscopic and microscopic analyses of the lungs showed increased metastasis in the EST-treated animals compared to controls, accompanied by an increase in VEGF systemic levels. Discussion Thus, these findings showed that intra-tumoral injection of T. canis EST antigens promote lung metastasis through modulation of the tumor immune microenvironment.
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Affiliation(s)
- Raúl Aragón-Franco
- Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional (ENCB-IPN), Ciudad de México, Mexico
| | - Rocío Alejandra Ruiz-Manzano
- Laboratorio de Neuroinmunoendocrinología, Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Karen Elizabeth Nava-Castro
- Laboratorio de Biología y Química Atmosférica, Departamento de Ciencias Ambientales, Instituto de Ciencias de la Atmósfera y Cambio Climático, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Víctor Hugo Del Rìo Araiza
- Laboratorio de Interacciones Endocrinoinmunitarias en Enfermedades Parasitarias, Facultad de Medicina Veterinaria y Zootecnia, Departamento de Parasitología, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Claudia Angelica Garay-Canales
- Laboratorio de Neuroinmunoendocrinología, Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Armando Pérez-Torres
- Departamento de Biologia Celular y Tisular, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Romel Chacón-Salinas
- Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional (ENCB-IPN), Ciudad de México, Mexico
| | - Manuel Iván Girón-Pérez
- Laboratorio de Inmunotoxicología, Secretaría de Investigación y Posgrado, Universidad Autónoma de Nayarit, Tepic, Nayarit, Mexico
| | - Jorge Morales-Montor
- Laboratorio de Neuroinmunoendocrinología, Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
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13
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Haugh AM, Daud AI. Current Role and Status for Intratumoral Injection Therapies in Metastatic Melanoma. Cancer J 2024; 30:108-112. [PMID: 38527264 DOI: 10.1097/ppo.0000000000000709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
ABSTRACT Intratumoral therapies represent a unique avenue for drug development in melanoma as patients often have accessible lesions that are particularly amenable to these approaches. In addition, a majority of intratumoral therapies have focused on stimulating antitumor immune responses, making them a particularly attractive option for use in melanoma. In this review, we describe applications for talimogene laherparepvec, a US Food and Drug Administration-approved intratumoral therapy in melanoma, as well as several classes of intratumoral therapies in development including novel oncolytic viruses, mRNA-based intratumoral injections, and cytokines and other signaling molecules.
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14
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Abdelaty MH, Badran AI, Aborahma AM, Elheniedy MA, Kamhawy AH. Intralesional injection of bleomycin in the management of low flow vascular malformations: Results and factors affecting the outcome. J Vasc Surg Venous Lymphat Disord 2024; 12:101694. [PMID: 37890586 DOI: 10.1016/j.jvsv.2023.101694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE Ethanol has been a commonly used sclerosant for low-flow vascular malformations, but it carries a high risk of complications. Bleomycin has been recently introduced as a potentially effective treatment. The aim of this study was to evaluate the safety and efficacy of bleomycin intralesional injection for the treatment of low-flow vascular malformations and determine the different factors affecting the outcome. PATIENTS AND METHODS A total of fifty patients with low-flow vascular malformations were enrolled in the study between April 2020 and March 2022. All patients underwent preoperative duplex ultrasound and magnetic resonance angiography. The procedure was performed under ultrasound and fluoroscopic guidance. All patients were assessed for the objective improvement, ultrasound assessment, and patient-reported outcome. RESULTS The overall rate of objective improvement was 79.53% (78.05% in venous and 87.5% in lymphatic malformations), whereas 81.25% of the patients showed a degree of size reduction or complete obliteration on postoperative ultrasound. The patient-reported outcome analysis showed a statistically significant improvement in the mean score for the pain, overall symptoms, and self-confidence. On regression analysis, the only factor associated with poor objective outcome was diffuse lesions (ill-defined or extending in more than one body region or one compartment). No major complications were recorded. CONCLUSIONS Bleomycin intralesional injection is a safe and effective treatment for low-flow vascular malformations.
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Affiliation(s)
- Mohammed Hassan Abdelaty
- Department of Vascular and Endovascular Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.
| | - Ahmed Ibrahim Badran
- Department of Vascular and Endovascular Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Amr Mahmoud Aborahma
- Department of Vascular and Endovascular Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohammed Ahmed Elheniedy
- Department of Vascular and Endovascular Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Adel Husseiny Kamhawy
- Department of Vascular and Endovascular Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
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15
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Kozub A, Suleja A, Chłosta M, Kupilas A, Pradere B, Rivas JG, Rajwa P, Miszczyk M. Current trends in non-surgical management of Peyronie's disease-A narrative review. Andrology 2024; 12:505-517. [PMID: 37593783 DOI: 10.1111/andr.13512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023]
Abstract
Peyronie's disease (PD) is a connective tissue disorder affecting the tunica albuginea. It can cause pain and penile deformation, and its prevalence increases with age. Although surgery is the gold standard for the chronic phase of the disease, there are several conservative treatment methods available, and the optimal management of the acute phase of the disease remains a matter of debate. In this article, we aim to summarize the recent trends in research on the subject of non-surgical treatment of PD. The search was performed in PubMed, Scopus, and Web of Science databases and included studies in English published between 2012 and 2022 investigating the clinical outcomes of non-surgical PD management in humans. We have identified 20 distinct conservative treatment strategies. Among the oral therapeutics, only the use of phosphodiesterase type 5 inhibitors is currently recommended for clinical use in patients with concomitant erectile dysfunction. The use of collagenase from Clostridium histolyticum is supported by the best quality evidence in terms of intralesional injections for patients suffering from significant penile curvature; however, interferon alpha-2b can also be an option in such patients. Among other non-invasive methods, extracorporeal shockwaves can be useful for pain reduction, and penile traction therapy can lead to a reduction in penile curvature and plaque size. Despite a wide range of non-surgical methods available for PD treatment, the majority are not supported by sufficient scientific evidence, and the treatment efficacy is underwhelming. Further research on the subject of non-surgical management of PD is highly warranted.
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Affiliation(s)
- Anna Kozub
- IIIrd Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | - Agata Suleja
- IIIrd Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | - Marcin Chłosta
- Department of Urology, Jagiellonian University, Collegium Medicum, Krakow, Poland
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Andrzej Kupilas
- Department of Urology and Urooncology, City Hospital, Gliwice, Poland
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Department of Urology, University of Tours, Tours, France
| | - Juan Gómez Rivas
- Department of Urology, Hospital Clínico San Carlos, Madrid, Spain
| | - Paweł Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Marcin Miszczyk
- IIIrd Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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Lee J, Kurien L, Marciano T. Intralesional Injections of a TNF-α Inhibitor to Treat Orofacial Granulomatosis. Inflamm Bowel Dis 2024; 30:499-500. [PMID: 38243814 DOI: 10.1093/ibd/izae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Indexed: 01/22/2024]
Abstract
Lay Summary
We present the first documented case of successful treatment of orofacial granulomatosis by intralesional injections of a tumor necrosis factor α inhibitor to the lip. Our patient had rapid symptomatic improvement after 3 injections, and near resolution within 4 months of anti-tumor necrosis factor α therapy.
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Affiliation(s)
- Jasmine Lee
- Department of Pediatrics, NYU Langone Hospital - Long Island, Mineola, NY, USA
| | - Lisa Kurien
- Department of Pediatrics, NYU Langone Hospital - Long Island, Mineola, NY, USA
| | - Tuvia Marciano
- Department of Pediatrics, NYU Langone Hospital - Long Island, Mineola, NY, USA
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17
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Lin J, Wang X. Effects of botulinum toxin type A in the prevention and treatment of facial hypertrophic scars: A meta-analysis. Int Wound J 2024; 21:e14796. [PMID: 38494191 PMCID: PMC10944687 DOI: 10.1111/iwj.14796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/04/2024] [Indexed: 03/19/2024] Open
Abstract
A meta-analysis was conducted to comprehensively evaluate the prophylactic and therapeutic efficacy of botulinum toxin type A (BTX-A) in the treatment of facial hypertrophic scars. Computerised searches were performed in databases, from their inception to November 2023, including Embase, Google Scholar, Cochrane Library, Wanfang, PubMed and China National Knowledge Infrastructure databases, focusing on randomised controlled trials (RCTs) that investigated the use of BTX-A for treating facial hypertrophic scars. Two researchers independently screened the literature, extracted data and conducted quality assessments. Stata 17.0 software was employed for data analysis. Seventeen RCTs were ultimately included, involving 1605 patients who underwent facial cosmetic surgery. The analysis revealed that compared with conventional treatments, BTX-A significantly reduced visual analogue scale (VAS) scores (standardized mean difference [SMD]: -3.50, 95% confidence interval [CI]: -5.16 to -1.84, p < 0.001) and Vancouver scar scale (VSS) scores (SMD: -2.86, 95% CI: -4.03 to -1.68, p < 0.001), and narrowed scar width (SMD: -1.80, 95% CI: -2.48 to -1.13, p < 0.001), while also enhancing the overall effectiveness of the treatment. This study indicates that BTX-A is an effective modality in the prophylaxis and treatment of facial hypertrophic scars, significantly alleviating scar-related pain and preventing scar widening, and is thus worthy of broader clinical application.
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Affiliation(s)
- Jin Lin
- Department of DermatologyThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)HangzhouChina
| | - Xiao Wang
- Department of GeriatricsThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)HangzhouChina
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18
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Hu Y, Cheng Y, Jie W. Analysis of the effectiveness of PDT with 5-aminolevulinic acid in comparison to blue/red light combined with intralesional triamcinolone injection in treatment of severe inflammatory acne: A retrospective study. J Cosmet Dermatol 2024; 23:849-856. [PMID: 37881149 DOI: 10.1111/jocd.16045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/19/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE In this study, the therapeutic effect of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in comparison to blue/red light combined with intralesional triamcinolone injection for severe inflammatory acne was evaluated and analyzed. METHODS One hundred and four cases of severe inflammatory acne were analyzed in this study. They were divided into two groups as control and observation groups, 52 cases in each group. The control group (group A) received red and blue light combined with triamcinolone injection and lidocaine injection (1:4), while the observation group (Group B) was treated with ALA-PDT. Finally, the therapeutic effect and the occurrence of adverse reactions were compared between the two groups. RESULTS After 2, 4 and 6 weeks, the effectiveness rates of group B was 28.85%, 75.00%, and 86.54%, respectively while it was 9.62%, 51.92%, and 69.23%, respectively in group A. The difference between A and B was statistically remarkable (χ2 = 6.1905, 5.9713, 4.5217, p = 0.0128, 0.0145, 0.0335 at p < 0.05). In addition, the incidence of adverse reactions in B was 5.77%, lower than A (32.69%). This difference between A and B was statistically remarkable (χ2 = 12.1333, p = 0.0005). After 2, 4, and 6 weeks of treatment, the number of residual lesions in the group B group was remarkably lower than group A (p < 0.01). There was remarkable difference in the incidence of pain, burning sensation, pigmentation and erythema between the two groups. CONCLUSIONS The therapeutic effect of ALA-PDT in the treatment of severe acne is better than red blue light combined with triamcinolone injection and lidocaine injection. In addition, ALA-PDT has an ideal effect in the treatment of severe acne.
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Affiliation(s)
- Yi Hu
- Department of Dermatology and Venereology, The Eighth Hospital of Wuhan, Wuhan, China
| | - Yang Cheng
- Dermatological Department, Wuhan No.1 Hospital, Wuhan, China
| | - Wang Jie
- Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
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19
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López Sanz P, Fernández-Parrado M, Escario Travesedo E. [Translated article] Differentiating Keratoacanthoma From Squamous Cell Carcinoma: Are We Losing the Battle or Our Bearings? - Comment on "Intralesional Methotrexate for Keratoacanthomas: A Case Series". Actas Dermosifiliogr 2024; 115:T328-T329. [PMID: 38224736 DOI: 10.1016/j.ad.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/08/2023] [Indexed: 01/17/2024] Open
Affiliation(s)
- P López Sanz
- Servicio de Dermatología, Hospital General Universitario de Albacete, Albacete, Spain.
| | - M Fernández-Parrado
- Servicio de Dermatología, Hospital Universitario de Navarra, Pamplona, Spain
| | - E Escario Travesedo
- Servicio de Dermatología, Hospital General Universitario de Albacete, Albacete, Spain
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20
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López Sanz P, Fernández-Parrado M, Escario Travesedo E. Differentiating Keratoacanthoma From Squamous Cell Carcinoma: Are We Losing the Battle or Our Bearings? - Comment on "Intralesional Methotrexate for Keratoacanthomas: A Case Series". Actas Dermosifiliogr 2024; 115:328-329. [PMID: 37716500 DOI: 10.1016/j.ad.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/08/2023] [Indexed: 09/18/2023] Open
Affiliation(s)
- P López Sanz
- Servicio de Dermatología, Hospital General Universitario de Albacete, Albacete, España.
| | - M Fernández-Parrado
- Servicio de Dermatología, Hospital Universitario de Navarra, Pamplona, España
| | - E Escario Travesedo
- Servicio de Dermatología, Hospital General Universitario de Albacete, Albacete, España
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21
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Buechler CR, Anderson ZJ, Kullberg SA, Miller DD, Ahiskali A, Schut R, Hylwa SA. Successful Treatment of Recalcitrant Mpox Lesions With Intralesional Cidofovir in a Patient With HIV/AIDS. JAMA Dermatol 2024; 160:235-236. [PMID: 38055229 DOI: 10.1001/jamadermatol.2023.4727] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
This case report describes a man in his 50s with HIV/AIDS who presented with widely scattered recalcitrant mpox lesions.
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Affiliation(s)
- Connor R Buechler
- Department of Dermatology, University of Minnesota, Minneapolis
- Department of Internal Medicine, University of Minnesota, Minneapolis
| | - Zachary J Anderson
- Department of Internal Medicine, Hennepin Healthcare, Minneapolis, Minnesota
| | - Sara A Kullberg
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Daniel D Miller
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Aileen Ahiskali
- Department of Pharmacy, Hennepin Healthcare, Minneapolis, Minnesota
| | - Ronald Schut
- Department of Infectious Diseases, Hennepin Healthcare, Minneapolis, Minnesota
| | - Sara A Hylwa
- Department of Dermatology, University of Minnesota, Minneapolis
- Department of Dermatology, Hennepin Healthcare, Minneapolis, Minnesota
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22
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Xu JH, Zhang CX, Cang AJ, Yan R, Liu SW, Liu R, Zou NJ, Wang SN, Xu H, Li LS. Anti-Melanoma Activity of Single Intratumoral Injection of ZnPc Micelles Mixed With in situ Gel in B16 Bearing Mouse. J Pharm Sci 2024; 113:463-470. [PMID: 37852536 DOI: 10.1016/j.xphs.2023.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 10/20/2023]
Abstract
Photodynamic therapy (PDT) is a potential treatment strategy for melanoma. As a second-generation photosensitizer, Zinc phthalocyanine (ZnPc) has many advantages for anti-tumor PDTs, such as strong absorption in the red and near infrared regions, high photo and chemical stability, etc. However, ZnPc has a poor water solubility and is apt to aggregate due to the π-π interaction between molecules, which limits its applications. In this study, various solvents and surfactants were screened for dissolving ZnPc and preparing ZnPc@SDC-TPGS micelle and thermosensitive in situ gel. After the cytotoxic effects of thermosensitive gels on PDT were tested, the antitumor effects on PDT of them in mice by intratumoral injection were evaluated, including body weight, and tumor weight, volume and morphology. The cell death pathway and the relationship of reactive oxygen species yield with apoptotic rate of tumor cells induced by ZnPc in situ gel were investigated. The results were that N-methyl-pyrrolidone (NMP) mixed with 2 % SDC and aqueous solution containing 2 % TPGS and 2 % SDC were used to synthesize ZnPc@SDC-TPGS micelle and the thermosensitive in situ gel. The cytotoxic effects of thermosensitive gels showed good tumor suppression of ZnPc@SDC-TPGS in situ gel and no toxicity of the blank gel. Intratumoral injection in situ gel containing 3 µg ZnPc under irradiation demonstrated good tumor inhibition in mice with melanoma. Apoptosis has been established as the primary pathway of cell death, and the production of reactive oxygen species (ROS) plays a crucial role in cellular apoptosis induced by ZnPc@SDC-TPGS in situ gel. In conclusion, the intratumoral injection of ZnPc@SDC-TPGS thermosensitive in situ gel provides a promising local treatment option for melanoma.
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Affiliation(s)
- Jing-Hua Xu
- School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, No. 26 Huatuo Road, Benxi 117004, China
| | - Chun-Xue Zhang
- School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, No. 26 Huatuo Road, Benxi 117004, China
| | - Ai-Jun Cang
- Department of Pharmacy, The People's Hospital of Liaoning Province, Shenyang 110016, China
| | - Ran Yan
- School of Pharmacy, Shenyang Pharmaceutical University, No. 26 Huatuo Road, Benxi 117004, China
| | - Shi-Wen Liu
- School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, No. 26 Huatuo Road, Benxi 117004, China
| | - Rui Liu
- School of Pharmacy, Shenyang Pharmaceutical University, No. 26 Huatuo Road, Benxi 117004, China
| | - Nv-Jie Zou
- School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, No. 26 Huatuo Road, Benxi 117004, China
| | - Shao-Ning Wang
- School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, No. 26 Huatuo Road, Benxi 117004, China
| | - Hui Xu
- School of Pharmacy, Shenyang Pharmaceutical University, No. 26 Huatuo Road, Benxi 117004, China
| | - Lin-Sen Li
- School of International Education, Shenyang Medical College, No. 146 Huanghe North Street, Shenyang 110034, China.
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Zagzoog FH, Mogharbel AM, Alqutub A, Bukhari M, Almohizea MI. Intralesional cidofovir vs. bevacizumab for recurrent respiratory papillomatosis: a systematic review and indirect meta-analysis. Eur Arch Otorhinolaryngol 2024; 281:601-627. [PMID: 37831132 DOI: 10.1007/s00405-023-08279-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Specific HPV types cause recurrent respiratory papillomatosis (R.R.P.). When administered intralesionally, cidofovir, an antiviral agent, has shown favorable outcomes in reducing papilloma. Bevacizumab, an angiogenesis inhibitor, has demonstrated improved R.R.P. However, both treatments lack FDA approval for R.R.P. Our study aims to evaluate the efficacy and safety of intralesional Cidofovir and Bevacizumab for R.R.P. and compare the two interventions. METHODS We searched five electronic databases to find relevant studies. After the screening, data were extracted from the included studies. Pooled ratios with 95% confidence intervals (CIs) were used for categorical outcomes, and mean difference (MD) was used for continuous outcomes. Statistical heterogeneity was evaluated using the chi-squared test for I2 statistics. The Cochrane Risk of Bias assessment tool was used to assess the methodological quality of randomized controlled trials (RCTs), while the National Institutes of Health's tool was used for observational studies. Analysis was done by Review Manager software. RESULTS In our comprehensive meta-analysis of 35 articles involving 836 patients, cidofovir demonstrated an overall remission ratio of (0.90 [95% CI: 0.83, 0.98], p = 0.01), while bevacizumab (0.92 [95% CI: 0.79, 1.07]), p = 0.3). The complete remission ratio for cidofovir was (0.66 [95% CI: 0.57, 0.75], p > 0.0001), while bevacizumab was (0.29 [95% CI: 0.12, 0.71], p = 0.07). In partial remission, Bevacizumab showed a higher ratio than Cidofovir 0.74 [0.55, 0.99] vs. 0.40 [0.30, 0.54]. Bevacizumab had a pooled ratio of 0.07 [95% CI: 0.02, 0.30] in terms of no remission, indicating better outcomes compared to Cidofovir with a ratio of 0.28 [95% CI: 0.16, 0.51]. Additionally, Cidofovir showed a favorable decrease in the Derkay Severity Score (DSS) with a mean difference (MD) of 1.98 [95% CI: 1.44, 2.52]. CONCLUSION Cidofovir had a higher impact on complete remission compared to Bevacizumab. Both showed partial remission, with Bevacizumab having a higher ratio. Moreover, Cidofovir showed a significant decrease in DSS. Bevacizumab had lower rates of no remission and recurrence and fewer adverse events compared to Cidofovir. However, the difference between the two treatments was not significant, except for partial remission.
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Affiliation(s)
- Faisal H Zagzoog
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Ahmed M Mogharbel
- Department of Otolaryngology, Head and Neck Surgery, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Abdulsalam Alqutub
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Manal Bukhari
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed I Almohizea
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Sayan A, Taibjee S, Ilankovan V. Intralesional methotrexate as non-surgical therapy for giant keratoacanthoma on the nose. Br J Oral Maxillofac Surg 2024; 62:203-205. [PMID: 38267280 DOI: 10.1016/j.bjoms.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 01/26/2024]
Abstract
Keratoacanthoma is an epithelial tumour derived from hair follicles. Clinical and histopathological features of keratoacanthoma can resemble that of squamous cell carcinoma. Different treatment alternatives have been described over the years including intralesional methotrexate injection. We present an interesting case of treatment of solitary keratoacanthoma lesion on the nose with intralesional methotrexate as non-surgical therapy.
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Affiliation(s)
- Anna Sayan
- Oxford University Hospitals NHS Trust, UK.
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25
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Xu Q, Bao C, Liu J, Zou Y, Zhu Y, Shen S, Fang F, Wang S, Lin M, Huang J, Gong T, Cheng B, Huang Z, Ji C. Effect of Epidermoid Cysts on the Efficacy of Intralesional Corticosteroid Therapy for Hypertrophic Scars and Keloids: A Prospective Pilot Study. Dermatol Surg 2024; 50:160-164. [PMID: 37962160 DOI: 10.1097/dss.0000000000004001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
BACKGROUND Patients with hypertrophic scars (HSs) or keloids occasionally have epidermoid cysts (ECs), and the effect of ECs on the effectiveness of intralesional corticosteroids (ILCs) treatment in these patients has not been reported. OBJECTIVE This study aims to evaluate the influence of ECs on the outcomes of ILCs treatment in patients with HSs or keloids. MATERIALS AND METHODS This prospective study included 572 patients with keloids ( n = 461) or HSs ( n = 111). Patients received intralesional triamcinolone acetonide injection (0.05 mL/injection) at a concentration of 40 mg/mL and every 28 days for 4 sessions, with a 1-year follow-up. RESULTS A higher incidence of ECs was observed in keloid patients (16.92%) compared with HSs patients (7.21%). Keloid patients with ECs were older ( p = .008) and had a longer disease duration ( p = .0148), higher Vancouver scar scale (VSS) scores ( p = .04), and greater thickness ( p = .006). Keloid patients with ECs showed less improvement in VSS scores ( p < .0001) and thickness ( p < .0001) after ILCs treatment, with a higher recurrence rate ( p < .0001). The overall complication rate in keloid patients with ECs after ILCs treatment was 49.51%. CONCLUSION Epidermoid cysts under keloids were associated with a poor response to ILCs therapy. Therefore, it is recommended to incorporate ultrasonography as a routine examination for keloid patients to aid in better decision making in clinical practice.
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Affiliation(s)
- Qiuyun Xu
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Chengbei Bao
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jian Liu
- Fuzhou Minebuty Medical Cosmetology Clinic, Fuzhou, Fujian, China
| | - Ying Zou
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yanting Zhu
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Shuyi Shen
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Fang Fang
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Songyu Wang
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Mengting Lin
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jinwen Huang
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Ting Gong
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Central Laboratory, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Bo Cheng
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Zugen Huang
- Department of Plastic and Cosmetic Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Chao Ji
- Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Tashbayev B, Chen X, Utheim TP. Chalazion Treatment: A Concise Review of Clinical Trials. Curr Eye Res 2024; 49:109-118. [PMID: 37937798 DOI: 10.1080/02713683.2023.2279014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/30/2023] [Indexed: 11/09/2023]
Abstract
A chalazion is one of the most common eye conditions presenting as a mass lesion of the eyelids. It is seen in all age groups. Chalazion is a non-inflammatory process and develops due to retained secretion of the meibomian or Zeis glands. Treatment of choice differs among clinicians and may include application of warm compress onto eyelids, lid hygiene, using local antibiotic ointment with or without steroids, injecting steroid solution (triamcinolone acetonide) into the lesion and surgical removal of the lesion by incision and curettage. In addition, there are some other experimented methods such as injection of botulinum toxin A, tarsal trephination, removal of chalazion by application of CO2 laser or cryogenic action. However, there is currently no commonly agreed treatment of choice. In this review, we aimed to summarize findings from clinical trials and hopefully, identify a treatment of choice in chalazion.
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Affiliation(s)
- Behzod Tashbayev
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- The Norwegian Dry Eye Clinic, Oslo, Norway
| | - Xiangjun Chen
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- The Norwegian Dry Eye Clinic, Oslo, Norway
- Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway
- Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway
| | - Tor Paaske Utheim
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- The Norwegian Dry Eye Clinic, Oslo, Norway
- Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway
- Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
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27
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Larson H, Savage J, Brearton K, Warner R, Ziegelmann M, Kohler T, Trost L. Outcomes of collagenase Clostridium histolyticum in men with ventral curvatures: an updated series. J Sex Med 2024; 21:169-174. [PMID: 38141054 DOI: 10.1093/jsxmed/qdad167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/23/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The efficacy and safety of collagenase Clostridium histolyticum (CCH) have been demonstrated in the treatment of men with Peyronie's disease (PD); however, the pivotal clinical trials excluded men with ventral penile curvature. AIM The study sought to evaluate outcomes of CCH treatment in men with ventral curvatures secondary to PD. METHODS Men with PD treated with CCH were identified from a prospective database. Patients received up to 4 series of CCH injections using a progressively modified protocol over time. Results were compared between those with baseline ventral vs nonventral penile curvatures. OUTCOMES Changes in penile curvature, Peyronie's Disease Questionnaire scores, International Index of Erectile Function scores, nonstandardized assessments, and adverse events. RESULTS A total of 560 men with PD (85 ventral curvature, 475 nonventral curvature) were included in the analysis. Baseline median curvature was 60.0° (interquartile range, 48.8°-75.0°) in the ventral cohort and 65.0° (interquartile range, 45.0°-80.0°) in the nonventral cohort. Median change from baseline penile curvature was -25.0° in the ventral cohort vs -24.0° in the nonventral cohort (P = .08, between-group comparison), which corresponded to curvature reductions of 44.7% and 33.6%, respectively (P = .03). In the subset of patients who completed CCH treatment (ie, received 8 injections or discontinued early because of patient satisfaction with curvature reduction), median change from baseline was -35.0° in the ventral cohort vs -25.0° in the nonventral cohort (P < .05); median percent improvement was 48.3% and 37.5%, respectively (P = .11). Median change from baseline in Peyronie's Disease Questionnaire and International Index of Erectile Function domain scores and adverse events were similar between cohorts, with the exception of possibly higher hematoma rates in the nonventral group (50% vs 37%; P = .05). No urethral injuries were sustained in either cohort. CLINICAL IMPLICATIONS Data support the use of CCH for the treatment of ventral as well as nonventral penile curvatures in men with PD. STRENGTHS AND LIMITATIONS Study strengths are the inclusion of a general clinical population of men with PD, the prospective design, and the relatively large series of men with ventral curvature. Limitations include the single-center and observational nature of the study. CONCLUSION CCH was safe and effective in the treatment of both ventral and nonventral penile curvatures in men with PD.
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Affiliation(s)
- Henry Larson
- Brigham Young University, Department of Physiology and Developmental Biology, Provo, UT 84602, United States
| | - Joshua Savage
- Male Fertility and Peyronie's Clinic, Orem, UT 84057, United States
| | - Klint Brearton
- Male Fertility and Peyronie's Clinic, Orem, UT 84057, United States
| | - Riley Warner
- Male Fertility and Peyronie's Clinic, Orem, UT 84057, United States
| | | | - Tobias Kohler
- Mayo Clinic, Department of Urology, Rochester, MN 55905, United States
| | - Landon Trost
- Brigham Young University, Department of Physiology and Developmental Biology, Provo, UT 84602, United States
- Male Fertility and Peyronie's Clinic, Orem, UT 84057, United States
- Mayo Clinic, Department of Urology, Rochester, MN 55905, United States
- CURE PD, Orem, UT 84057, United States
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28
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Lin SN, Wu YM, Siow TY, Yeh CH, Toh CH, Tseng TY, Wong HF. Sclerotherapy with intralesional bleomycin injection under guidance of multi-slice CT for retrobulbar orbital low-flow vascular lesions-single-center experience. Br J Radiol 2024; 97:186-194. [PMID: 38263834 PMCID: PMC11027304 DOI: 10.1093/bjr/tqad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/02/2023] [Accepted: 10/22/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE This study investigated the safety and efficacy of sclerotherapy with intralesional bleomycin injection (IBI) for retrobulbar orbital low-flow vascular lesions under multi-slice computed tomography (CT) guidance. METHODS Between January 2010 and September 2021, consecutive patients with retrobulbar orbital low-flow vascular lesions who underwent CT-guided IBI at a tertiary centre in Taiwan were enrolled. Their medical records and imaging data were retrospectively collected. RESULTS This study enrolled 13 patients (7 male and 6 female patients; age range: 1-57 years; mean age: 25.9 years) with lymphatic malformation (LM, n = 4), venolymphatic malformation (n = 1), and venous malformation (VM, n = 8). The overall radiological response rate was 76.9% (10 of 13); the radiological response rate was 75.0% in the VM group (6 of 8) and 75.0% in the LM group (3 of 4). Moreover, 3 patients (23.1%) had minor complications and 1 (7.7%) had a major complication. The mean clinical and radiological follow-up was 8.3 months and no recurrence or progression was reported. CONCLUSION CT-guided IBI is an effective and relatively safe minimally invasive treatment for retrobulbar orbital low-flow vascular lesions, with an overall radiological response rate of 76.9% in a mean of 1.5 sessions and a low complication rate. ADVANCES IN KNOWLEDGE CT-guided sclerotherapy with IBI is a relatively safe, effective, and feasible alternative treatment option for retrobulbar orbital low-flow vascular lesions.
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Affiliation(s)
- Shin-Nan Lin
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan
| | - Yi-Ming Wu
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan
| | - Tiing-Yee Siow
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan
| | - Chih-Hua Yeh
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan
| | - Cheng-Hong Toh
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan
| | - Ti-Yung Tseng
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan
| | - Ho-Fai Wong
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan
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29
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Hosseinpour A, Soltani M, Souri M. Improving tumor treatment through intratumoral injection of drug-loaded magnetic nanoparticles and low-intensity ultrasound. Sci Rep 2024; 14:1452. [PMID: 38228704 PMCID: PMC10791673 DOI: 10.1038/s41598-024-52003-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/12/2024] [Indexed: 01/18/2024] Open
Abstract
The intratumoral injection of therapeutic agents responsive to external stimuli has gained considerable interest in treating accessible tumors due to its biocompatibility and capacity to reduce side effects. For the first time, a novel approach is explored to investigate the feasibility of utilizing low-intensity ultrasound in combination with intratumoral injection of drug-loaded magnetic nanoparticles (MNPs) to thermal necrosis and chemotherapy with the objective of maximizing tumor damage while avoiding harm to surrounding healthy tissue. In this study, a mathematical framework is proposed based on a multi-compartment model to evaluate the effects of ultrasound transducer's specifications, MNPs size and distribution, and drug release in response to the tumor microenvironment characteristics. The results indicate that while a higher injection rate may increase interstitial fluid pressure, it also simultaneously enhances the concentration of the therapeutic agent. Moreover, by increasing the power and frequency of the transducer, the acoustic pressure and intensity can be enhanced. This, in turn, increases the impact on accumulated MNPs, resulting in a rise in temperature and localized heat generation. Results have demonstrated that smaller MNPs have a lower capacity to generate heat compared to larger MNPs, primarily due to the impact of sound waves on them. It is worth noting that smaller MNPs have been observed to have enhanced diffusion, allowing them to effectively spread within the tumor. However, their smaller size also leads to rapid elimination from the extracellular space into the bloodstream. To summarize, this study demonstrated that the local injection of MNPs carrying drugs not only enables localized chemotherapy but also enhances the effectiveness of low-intensity ultrasound in inducing tissue thermal necrosis. The findings of this study can serve as a valuable and reliable resource for future research in this field and contribute to the development of personalized medicine.
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Affiliation(s)
- Asma Hosseinpour
- Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Madjid Soltani
- Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran.
- Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, Canada.
- Centre for Biotechnology and Bioengineering (CBB), University of Waterloo, Waterloo, Canada.
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, Canada.
- Centre for Sustainable Business, International Business University, Toronto, Canada.
| | - Mohammad Souri
- Department of NanoBiotechnology, Pasteur Institute of Iran, Tehran, Iran
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Ji Chun E, Chul Chung H, Seok Kim S, Woo Kim C. Pseudocyst of the auricle treated with intralesional sodium tetradecyl sulphate injection. Indian J Dermatol Venereol Leprol 2024; 90:113-114. [PMID: 37317723 DOI: 10.25259/ijdvl_208_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/27/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Eun Ji Chun
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Gangdong-gu, Seoul, Republic of Korea
| | - Hyun Chul Chung
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Gangdong-gu, Seoul, Republic of Korea
| | - Sang Seok Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Gangdong-gu, Seoul, Republic of Korea
| | - Chul Woo Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Gangdong-gu, Seoul, Republic of Korea
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31
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Zaky MS, Atallah RB, Mohyeldeen AMS, Elsaie ML. Intralesional injection of tuberculin purified protein derivative (PPD) versus measles, mumps, and rubella (MMR) vaccine in treatment of molluscum contagiosum: a comparative study. Sci Rep 2024; 14:288. [PMID: 38167543 PMCID: PMC10762225 DOI: 10.1038/s41598-023-49182-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Molluscum contagiosum (MC) is a skin and mucous membrane infection caused by the molluscum virus (MCV). To evaluate safety and efficacy of intralesional injection of tuberculin purified protein derivative (PPD) antigen injection versus MMR (mumps, measles, rubella) antigen for the treatment of molluscum contagiosum (MC). A total of thirty clinically confirmed patients of molluscum were recruited for this trial. Patients who were divided into three groups (A, B and C). Each group consisted of (30) patients. Group (A) subjects received intralesional MMR injections, group (B) subjects received intralesional PPD injection and group (C) received intralesional saline injection. The results of the present study revealed complete clearance of the injected lesions in 12 patients (80%), partial response in 3 patients (20%) of group (A). In group (B), complete clearance of the treated warts was observed in 11 patients (73.3%) and partial response in 4 (26.7%) of patients. In group (C), the majority of patients 8 (53.3%) demonstrated no response while 7 (46.7%) patients showed only partial clearance. We established a good safety and efficacy profile for tuberculin PPD and MMR antigens in treatment of molluscum contagiosum.
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Affiliation(s)
- Mohamed S Zaky
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Rabie B Atallah
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Aya M Saad Mohyeldeen
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Mohamed L Elsaie
- Department of Dermatology, Venereology and Andrology, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt.
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Anggraini YE, Trisnowati N, Martien R, Danarti R. A randomised clinical trial study assessing the efficacy of 5% losartan potassium loaded in ethosomal gel to treat human keloids: a trial protocol. Trials 2024; 25:12. [PMID: 38167064 PMCID: PMC10759551 DOI: 10.1186/s13063-023-07880-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Keloid is a skin disorder that results from excessive fibrous tissue growth in the area of the initial trauma. Treating keloids can be challenging since the success of various treatments varies from one study to another. Triamcinolone acetonide injection, a standard treatment, can cause undesirable side effects. Meanwhile, the effectiveness of existing topical therapies for keloids is not always reliable. The pro-inflammatory, pro-proliferative, and pro-fibrotic effects of angiotensin II in human skin contribute to keloid formation. Losartan potassium, an angiotensin II blocker, has the potential to act as an anti-keloid agent. Due to the thicker skin structure of a keloid and ease of application, ethosome gel is chosen as a safe and comfortable carrier for losartan potassium, making it a good choice for treating keloids. METHODS In this randomised clinical trial, 46 adults with keloids were divided into two treatment groups. One group of 23 participants received 5% losartan potassium loaded in ethosomal gel, while the other group of 23 participants received intralesional injections of 10% triamcinolone acetonide. Over 12 weeks, changes in POSAS 3.0 scores, degree of erythema and pigmentation, surface area, thickness, and pliability of the keloids will be measured at four different times: baseline, 4 weeks, 8 weeks, and 12 weeks. Statistical analysis will be conducted using SPSS software version 24, with a significance level of p < 0.05. DISCUSSION Losartan potassium is believed to be beneficial for keloid management because it inhibits the angiotensin II receptor, which plays a role in inflammation, proliferation, and fibrosis. This study examines the efficacy of 5% losartan potassium loaded in ethosomal gel for human keloids. TRIAL REGISTRATION Clinicaltrial.gov identifier NCT05893108 . Registered on 7 June 2023.
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Affiliation(s)
- Yuni Eka Anggraini
- Faculty of Medicine, Universitas Riau, Kota Pekanbaru, Indonesia
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Niken Trisnowati
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ronny Martien
- Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Retno Danarti
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
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Zucker I, Nackeeran S, Mirza S, Masterson TA. Risk Factors for Penile Fracture After Intralesional Collagenase Clostridium histolyticum in Peyronie's Disease. Urology 2024; 183:117-120. [PMID: 37949243 DOI: 10.1016/j.urology.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/10/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To evaluate risk factors leading to corporal rupture after Collagenase Clostridium histolyticum (CCh). Peyronie's disease (PD) is a fibrotic condition of the penis characterized by abnormal plaque formation. Intralesional CCh is the only FDA-approved medication for PD, however, it can lead to corporal rupture, a potential surgical emergency. METHODS We retrospectively reviewed medical records from Veterans diagnosed with PD who were under treatment with CCh using the Veterans Administration Informatics and Computing Infrastructure (VINCI). Using International Classification of Diseases and Current Procedural Terminology codes, we identified men who suffered a corporal rupture after CCh. Individual charts were reviewed to determine potential risk factors and events leading to corporal rupture. RESULTS We identified 17,647 veterans who were diagnosed with PD, of which 8.7% (1541) received at least one injection of CCh for PD. Of them, 0.7% (11/1541) veterans suffered corporal rupture. Within these 11 patients, the median number of CCH injections was 6 with a median initial curvature of 35°. Fracture occurred at a median of 8days after CCH injection. The majority of fractures were secondary to spontaneous erections or sexual intercourse. Finally, six patients had their fracture repaired surgically while the remaining were managed conservatively. CONCLUSION Most fractures occurred within 2weeks of CCh injections and were associated with sexual intercourse and spontaneous morning erections.
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Affiliation(s)
- Isaac Zucker
- Department of Urology, University of Toledo, Toledo, OH
| | - Sirpi Nackeeran
- Department of Urology, University of California San Diego, San Diego, CA
| | | | - Thomas A Masterson
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL.
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Bernabe RM, Won P, Lin J, Pham C, Madrigal P, Yenikomshian H, Gillenwater TJ. Combining scar-modulating agents for the treatment of hypertrophic scars and keloids: A systematic review. J Plast Reconstr Aesthet Surg 2024; 88:125-140. [PMID: 37979279 DOI: 10.1016/j.bjps.2023.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/04/2023] [Accepted: 10/09/2023] [Indexed: 11/20/2023]
Abstract
Injury to the skin can cause abnormal wound healing and continuous inflammation that leads to the formation of hypertrophic scars and keloids. These lesions often cause significant negative impact on a patient's life due to aesthetic, physical, social, and psychological consequences. Numerous treatment modalities exist for these hypertrophic scars and keloids, which include silicone sheeting, pressure garments, intralesional injection/topical application of scar-modulating agents, laser therapy, and surgical excision. Due to increased efficacy, an evolving treatment paradigm encourages the use of multiple treatment modalities instead of one treatment modality. However, no gold standard treatment exists for these lesions, leaving many people with unsatisfactory results. Adding scar-modulating agents such as 5-Fluorouracil, bleomycin, or Botulinum Toxin A to triamcinolone monotherapy has emerged as a potential drug combination for treating hypertrophic scars and keloids. We sought to critically analyze the evidence that exists for the use of more than one scar-modulating agent. This was done by conducting a systematic review to determine the efficacy of these combined drug regimens. We found that many of these combinations show evidence of increased efficacy and fewer/similar adverse events to triamcinolone monotherapy. Triamcinolone and 5-Fluorouracil showed the strongest and most consistent evidence out of all combinations. With this review, we intend to encourage more research into unique drug combinations that may improve outcomes for patients with symptomatic hypertrophic scars or keloids.
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Affiliation(s)
- Rendell M Bernabe
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Paul Won
- University of Southern California Keck School of Medicine, Los Angeles, CA, United States
| | - Joshua Lin
- University of Southern California Keck School of Medicine, Los Angeles, CA, United States
| | - Christopher Pham
- University of Southern California, Division of Plastic and Reconstructive Surgery, Los Angeles, CA, United States
| | - Paloma Madrigal
- University of Southern California Keck School of Medicine, Los Angeles, CA, United States
| | - Haig Yenikomshian
- University of Southern California, Division of Plastic and Reconstructive Surgery, Los Angeles, CA, United States
| | - T Justin Gillenwater
- University of Southern California, Division of Plastic and Reconstructive Surgery, Los Angeles, CA, United States.
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Alshuaibi M, Zugail AS, Lombion S, Beley S. New protocol in the treatment of Peyronie's disease by combining platelet-rich plasma, percutaneous needle tunneling, and penile modeling: Preliminary results. Fr J Urol 2024; 34:102526. [PMID: 37777436 DOI: 10.1016/j.purol.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/03/2023] [Accepted: 09/08/2023] [Indexed: 10/02/2023]
Abstract
INTRODUCTION Intra-lesional injections of collagenase (Xiapex®) were the only non-invasive treatment option for Peyronie's disease (PD), until their withdrawal from the European market. OBJECTIVE To evaluate the feasibility, efficacy, and safety of a combined treatment of percutaneous needle tunnelling (PNT) with penile modelling (PM) and the injection of platelet-rich plasma (PRP) under general anesthesia in the treatment of PD. PATIENTS AND METHOD A prospective case series study included patients with PD in a stable phase who underwent this procedure between March 2020 and January 2023. The main outcome was an improvement in curvature. RESULT Thirty-six patients underwent this novel approach for the treatment of PD. The pretreatment mean±standard deviation (SD) curvature degree was 57.5±20.61° (range 20-90°). After the protocol, the mean curvature degree was 40.86±25.13° (range 0-90°). The curvature angle improved significantly (P=0.0001), with a mean improvement difference of 16.85±14.81° (range 0-50°) and a mean improvement percentage of 47.7±40.29% (range 0-100%). CONCLUSION Our preliminary experience suggests that PNT and PRP injections with PM are effective and safe for the treatment of penile deformity of PD. LEVEL OF EVIDENCE 4: case series study.
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Affiliation(s)
- M Alshuaibi
- Department of Urology, Clinique Turin, Groupe Almaviva Santé, Paris, France; Department of Urology, Faculty of Medicine, University of Ha'il, Ha'il, Saudi Arabia.
| | - A S Zugail
- Department of Urology, Clinique Turin, Groupe Almaviva Santé, Paris, France; Department of Urology, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - S Beley
- Department of Urology, Clinique Turin, Groupe Almaviva Santé, Paris, France
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Park TH. A Triple Combination Therapy Using 2-mm Biopsy Punch for the Treatment of Multifocal Keloids. Dermatol Surg 2024; 50:41-46. [PMID: 37788236 DOI: 10.1097/dss.0000000000003955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
BACKGROUND Keloid treatment is challenging. The surgical approach can be divided into complete excision versus partial excision. OBJECTIVE The current study aims to introduce our novel surgical approach of partial excision using a 2-mm punch biopsy device to treat refractory multifocal keloids in the trunk. MATERIALS AND METHODS This is a case series of 30 patients with refractory multifocal keloids treated with a triple combination therapy consisting of a punch-assisted partial excision and intralesional triamcinolone injections followed by immediate single fractional electron beam radiotherapy within 8 hours, postoperatively. The follow-up period was 12 months. The primary outcome was recorded as recurrence versus nonrecurrence or aggravation versus remission . The secondary outcome was patient satisfaction as assessed by the POSAS. RESULTS The recurrence or aggravation of keloid was not found without complications. Scores obtained from the POSAS patient scale showed that pain, itchiness, color, stiffness, thickness, and irregularity significantly improved. CONCLUSION Our novel surgical approach using a 2-mm punch biopsy device effectively treats refractory multifocal keloids once considered intractable. Triple combination therapy of partial excision using a 2-mm punch biopsy device, intralesional triamcinolone injections, followed by immediate single fractional electron beam radiotherapy, is a safe, efficacious, and more convenient protocol to treat this condition.
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Affiliation(s)
- Tae Hwan Park
- Department of Plastic and Reconstructive Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
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Yang HA, Jheng WL, Yu J, Huang JY, Cheng KY, Lee JJ. Comparative Efficacy of Drug Interventions for Keloids: A Network Meta-analysis. Ann Plast Surg 2024; 92:S52-S59. [PMID: 38285997 DOI: 10.1097/sap.0000000000003759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
BACKGROUND Keloids are common benign skin lesions originating from a disorganized fibroproliferative collagen response; these lesions often lead to both physical and psychological problems. The optimal treatment for keloids is yet to be standardized. Intralesional injection, which is simple and nontraumatic, is one of the most commonly used treatment modalities for these lesions. In this study, we compared 5 different drugs (intralesional injections) for the treatment of keloids in terms of efficacy. METHODS We systemically searched relevant studies on PubMed, EMBASE, and Cochrane Library. Randomized clinical trials on the safety and efficacy of triamcinolone acetonide (TAC), 5-fluorouracil (5-FU), botulinum toxin A (BTA), verapamil, and bleomycin were included in this study. RESULTS This network meta-analysis included a total of 1114 patients from 20 randomized controlled trials. Botulinum toxin A alone and TAC plus 5-FU exhibited significantly better efficacy than did 5-FU, TAC, and verapamil. No significant difference in efficacy between BTA alone and TAC combined with 5-FU was observed. No significant differences were noted in the adverse event rate between BTA, TAC plus 5-FU, 5-FU, and TAC. Furthermore, we performed surface under the cumulative ranking curve analyses to predict the rank of each intervention (by efficacy and adverse event rate). The predicted ranking by efficacy was as follows: TAC plus 5-FU, BTA, bleomycin, TAC, 5-FU, and verapamil; the predicted ranking by adverse events was as follows: TAC, 5-FU, TAC plus 5-FU, and BTA. Funnel plot analysis revealed no publication bias. CONCLUSIONS Botulinum toxin A and TAC plus 5-FU appear to have outstanding therapeutic efficacy for keloids. The rate of adverse events was similar among BTA, TAC, 5-FU, and TAC plus 5-FU. Nonetheless, additional reviews of rigorous, large-scale randomized controlled trials are warranted for further validation of our findings.
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Affiliation(s)
| | | | | | | | - Kai-Yuan Cheng
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung City, Taiwan
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Kadunc BV, Brunner CHM. Treatment of keloids with intralesional bleomycin and electroporation. Int J Dermatol 2024; 63:e20-e22. [PMID: 37830302 DOI: 10.1111/ijd.16875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 08/08/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Affiliation(s)
- Bogdana V Kadunc
- Dermatologia, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | - Carlos H M Brunner
- Instituto de Ciências da Saúde - Medicina Veterinária, Universidade Paulista, São Paulo, Brazil
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Bekkers VZ, Khan F, Aarts P, Zdunczyk K, Prens EP, Wolkerstorfer A, Rissmann R, van Doorn MBA. Needle-free electronically-controlled jet injector treatment with bleomycin and lidocaine is effective and well-tolerated in patients with recalcitrant keloids. Lasers Surg Med 2024; 56:45-53. [PMID: 37933762 DOI: 10.1002/lsm.23737] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES The treatment of recalcitrant keloids is challenging. Although intralesional bleomycin using conventional needle injectors (CNI) is effective, it has important drawbacks, such as the need for repetitive and painful injections. Therefore, we aimed to evaluate the effectiveness, tolerability and patient satisfaction of intralesional bleomycin with lidocaine administered with a needle-free electronically-controlled pneumatic jet-injector (EPI) in recalcitrant keloids. METHODS This retrospective study included patients with recalcitrant keloids who had received three intralesional EPI-assisted treatments with bleomycin and lidocaine. Effectiveness was assessed using the Patient and Observer Scar Assessment Scale (POSAS) at baseline and four to six weeks after the third treatment. Additionally, treatment related pain scores numeric rating scale, adverse effects, patient satisfaction and Global Aesthetic Improvement Scale (GAIS) were assessed. RESULTS Fifteen patients with a total of >148 recalcitrant keloids were included. The median total POSAS physician- and patient-scores were respectively 40 and 41 at baseline, and reduced with respectively 7 and 6-points at follow-up ( p < 0.001; p < 0.001). The median pain scores during EPI-assisted injections were significantly lower compared to CNI-assistant injections, (2.5 vs. 7.0, respectively ( p < 0.001)). Adverse effects were mild. Overall, patients were "satisfied" or "very satisfied" with the treatments (14/15, 93.3%). The GAIS was "very improved" in one patient, "improved" in nine patients and "unaltered" in four patients. CONCLUSIONS EPI-assisted treatment with bleomycin and lidocaine is an effective, well tolerated, patient-friendly alternative for CNI in patients with recalcitrant keloid scars. Randomized controlled trials are warranted to confirm our findings and improve the clinical management of recalcitrant keloids.
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Affiliation(s)
- Vazula Zulfra Bekkers
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Fatima Khan
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Pim Aarts
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Katarzyna Zdunczyk
- Centre for Human Drug Research, Leiden, The Netherlands
- Division of BioTherapeutics, Leiden Academic Center for Human Drug Research, Leiden, The Netherlands
| | - Errol Prospero Prens
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Albert Wolkerstorfer
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Robert Rissmann
- Centre for Human Drug Research, Leiden, The Netherlands
- Division of BioTherapeutics, Leiden Academic Center for Human Drug Research, Leiden, The Netherlands
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martijn Bastiaan Adriaan van Doorn
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
- Centre for Human Drug Research, Leiden, The Netherlands
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Bekkers VZ, Van Eijsden C, Yin Q, Wolkerstorfer A, Prens EP, van Doorn MBA. Needle-Free Jet Injector-Assisted Triamcinolone Treatment of Keloids and Hypertrophic Scars is Effective and Well Tolerated in Children. Clin Drug Investig 2024; 44:51-57. [PMID: 38093082 DOI: 10.1007/s40261-023-01332-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Keloids and hypertrophic scars can cause severe pain, pruritus, and psychological distress. Conventional intralesional corticosteroid treatment with needle injections remains challenging, especially in children with needle phobia. OBJECTIVE We aimed to evaluate the effectiveness, tolerability, and patient satisfaction of intralesional treatment with triamcinolone acetonide using a needle-free electronic pneumatic jet injector in children with keloids and hypertrophic scars. METHODS A retrospective study was performed in children with keloids and hypertrophic scars who received intralesional triamcinolone acetonide treatments using an electronic pneumatic jet injector. Effectiveness was evaluated using the Patient and Observer Scar Assessment Scale and Global Aesthetic Improvement Score at follow-up versus baseline. Tolerability was assessed with reported adverse effects and injection-related pain using a visual analog scale. Satisfaction questionnaires were used to evaluate treatment-related patient satisfaction. RESULTS Six female patients and five male patients aged 5-17 years, with a total of >118 keloids or hypertrophic scars were included. Electronic pneumatic jet injector treatment led to a significant reduction in the total Patient and Observer Scar Assessment Scale observer and patient scores compared with baseline, with a median reduction of 28.9% and 23.8%, respectively (p = 0.005; p = 0.009). Median visual analog scale pain scores for electronic pneumatic jet injector treatment were significantly lower compared with needle injections, 3.0 versus 7.0, respectively (p = 0.027). No severe adverse effects were reported. Overall, 6 patients were 'satisfied' and five patients were 'very satisfied' with the treatment. CONCLUSIONS Electronic pneumatic jet injector-assisted intralesional triamcinolone acetonide is an effective and well-tolerated treatment for keloids and hypertrophic scars in children. It should be considered as an alternative non-traumatic delivery method, especially in children with needle phobia or severe pain during previous needle injections.
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Affiliation(s)
- Vazula Zulfra Bekkers
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Claire Van Eijsden
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Qi Yin
- Department of Dermatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Albert Wolkerstorfer
- Department of Dermatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Errol Prospero Prens
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
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Litaiem N, Cherif M, Zeglaoui F. Efficacy and Safety of Intralesional Tranexamic Acid Injections in the Treatment of Postoperative Scars: A Split-Scar Comparative Study. Dermatol Surg 2024; 50:116-117. [PMID: 37792644 DOI: 10.1097/dss.0000000000003959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Affiliation(s)
- Noureddine Litaiem
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Meriem Cherif
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Faten Zeglaoui
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Fawzy M, Al-Mokadem S, Alshereef M, Elkholy B. Narrowband ultraviolet B phototherapy combined with intralesional injection of either latanoprost or platelet-rich plasma for stable nonsegmental vitiligo. Photodermatol Photoimmunol Photomed 2024; 40:e12929. [PMID: 37984828 DOI: 10.1111/phpp.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/18/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Narrowband ultraviolet B (NB-UVB) phototherapy is the cornerstone of vitiligo treatment. Its combination with other treatments usually yields a better response. Latanoprost, a prostaglandin F2α analog, and autologous platelet-rich plasma (PRP) have been reported to be effective for vitiligo. AIM To evaluate the efficacy of NB-UVB combined with intralesional latanoprost or PRP for stable nonsegmental vitiligo (NSV). METHODS Sixty patients with stable NSV were recruited and randomly allocated to two equal groups. NB-UVB phototherapy was administered twice a week for all patients. Additionally, group A received intralesional latanoprost injections once weekly, while group B received intralesional autologous PRP injections every 2 weeks. RESULTS At 24 weeks, excellent repigmentation response was observed in 26.7% and 13.3% of patients in the latanoprost/NB-UVB and PRP/NB-UVB groups, respectively, with no significant difference in degrees of repigmentation between the two groups. However, the Vitiligo Extent Score for a Target Area (VESTA) score was significantly higher in the latanoprost/NB-UVB group (p = .032). Moreover, lesions located on nonacral skin responded significantly better than those on acral skin. Only erythema was significantly higher in the PRP/NB-UVB group, while the recurrence of depigmentation was significantly higher in the latanoprost/NB-UVB group. CONCLUSIONS Both latanoprost and PRP have the potential to be effective add-on therapies to NB-UVB phototherapy for stable NSV, with latanoprost resulting in a greater repigmentation response and PRP producing a more stable response.
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Affiliation(s)
- Manal Fawzy
- Department of Dermatology, Venereology & Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sahar Al-Mokadem
- Department of Dermatology, Venereology & Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mabrokah Alshereef
- Department of Dermatology, Venereology & Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Basma Elkholy
- Department of Dermatology, Venereology & Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Lehner K, Byrne E, Roshandel MR, Alom M, Helo S, Köhler T, Ziegelmann M. The Discontinuation Rate With Collagenase Clostridium histolyticum for Peyronie's Disease in a High-volume Practice Is Unexpectedly High: Identifying Opportunities for Patient Care Improvement. Urology 2024; 183:121-126. [PMID: 37949244 DOI: 10.1016/j.urology.2023.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/16/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To elucidate reasons for premature discontinuation of Collagenase Clostridium histolyticum (CCH) injections for the treatment of penile curvature associated with Peyronie's disease. METHODS A database of men who underwent CCH injections at a single institution was queried to identify men who completed fewer than 8 injections. Chart review was conducted to identify reasons for treatment discontinuation. When this could not be identified, patients were contacted first via the online patient portal and next by phone. RESULTS Of 406 patients who underwent CCH treatment, 133 did not complete 8 injections (32.8%). The most common reasons for discontinuation were satisfactory curve reduction (27%), unsatisfactory curve reduction (21%), bothersome side effect (15%), and pursuit of surgery (12%). Other less common reasons included other health concerns, pausing treatment due to the COVID-19 pandemic, high cost, transferring care elsewhere, and lack of awareness that more injections were indicated. CONCLUSION We present the largest series of patients to date dedicated to evaluation of CCH discontinuation. We find that up to 1/3 of patients who begin CCH injections will not complete the full treatment course. Understanding the reasons for discontinuation can help providers better stratify patients for CCH treatment vs other modalities. In addition, as previous studies indicate curvature improvements are equally likely to be seen in the final four injections as the first four, our data points to the potential impact of improved patient education for individuals who discontinue due to unsatisfactory curve reduction.
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Affiliation(s)
- Kelly Lehner
- Mayo Clinic Department of Urology, Rochester, MN.
| | - Eileen Byrne
- Mayo Clinic Department of Urology, Rochester, MN
| | | | - Manaf Alom
- Mayo Clinic Department of Urology, Rochester, MN
| | - Sevann Helo
- Mayo Clinic Department of Urology, Rochester, MN
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Karina K, Ekaputri K, Andrew H, Biben JA. Microneedle Electroporation for Intralesional Administration of Corticosteroid Treatment of Keloid Scar. Acta Derm Venereol 2023; 103:adv13402. [PMID: 38059802 PMCID: PMC10719861 DOI: 10.2340/actadv.v103.13402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/03/2023] [Indexed: 12/08/2023] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Karina Karina
- Klinik Hayandra, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia; Hayandra Lab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia; Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Jl. Rs. Fatmawati, Jakarta, Indonesia.
| | - Krista Ekaputri
- Klinik Hayandra, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
| | - Hubert Andrew
- Hayandra Lab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia; Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya no. 6, Jakarta Pusat, Indonesia
| | - Johannes Albert Biben
- Klinik Hayandra, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
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Sanjuan-Cervero R, Gomez-Herrero D, Peña-Molina F, de la Iglesia NH, Sanjuan-Arago A, Novoa-Parra CD. Patient Insight With Collagenase Treatment for Dupuytren: A Prospective Study. J Hand Surg Am 2023; 48:1274.e1-1274.e6. [PMID: 35718584 DOI: 10.1016/j.jhsa.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 03/08/2022] [Accepted: 04/22/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE There appears to be controversy regarding differing patient and physician perceptions of adverse effects (AEs) in the treatment of Dupuytren disease with collagenase clostridium histolyticum (CCH). The aim of this study was to compare the number, type, and severity of AEs perceived and reported by patients and by their physician METHODS: To assess AEs following CCH injection in a standardized way, patients were given a list of predefined complications and asked to rate their severity on a 4-point Likert scale ranging from 1 (serious) to 4 (insignificant). RESULTS Eighty-five patients were included. Patients reported fewer AEs than their physician (mean, 1.48 vs 2.18). There was no agreement between physician- and patient-reported AEs except for skin lacerations, which showed fair agreement (κ = 0.257). CONCLUSIONS Patients and physicians differ in their evaluation of AEs due to CCH treatment in Dupuytren disease. A fair level of agreement was observed for skin lacerations. CLINICAL RELEVANCE Greater consensus is needed when defining AEs associated with CCH in the treatment of Dupuytren disease.
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Affiliation(s)
| | - Diego Gomez-Herrero
- Pharmacy Department, Hospital Vithas 9 de Octubre, Valencia, Spain; Doctor of Pharmacy Program, University of Granada, Granada, Spain
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Park SJ, Shin SH, Koh YG, Kim GH, Rho NK, Park KY. Cold anesthesia for pain reduction during intralesional steroid injection for nodulocystic acne. J Cosmet Dermatol 2023; 22:3375-3378. [PMID: 37218601 DOI: 10.1111/jocd.15829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/02/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND In any dermatologic procedure, patient acceptance of treatment is heavily influenced by intraprocedural pain. Intralesional triamcinolone injections are very important in keloid scar and nodulocystic acne treatment. However, the main problem of needle-stick procedures is pain. Cryoanesthesia is ideally intended to cool only the epidermis during treatment and has advantage which did not require application time. AIMS The aim of this study was to investigate the pain-reducing effect and safety of CryoVIVE® (newly introduced cryoanesthesia device) during triamcinolone injections for nodulocystic acne in actual clinical settings. PATIENTS/METHODS In this two-staged, non-randomized clinical trial, a total of 64 subjects underwent intralesional triamcinolone injections for their acne lesions with cold anesthesia using CryoVIVE®. The pain intensity was assessed with Visual Analogue Scale (VAS) scores. Safety profile was also evaluated. RESULTS The mean pain VAS scores on the lesion with and without cold anesthesia were 3.667 and 5.933, respectively (p = 0.0001). No side effects, discoloration, and scarring were observed. CONCLUSION In conclusion, the anesthetic use of CryoVIVE® with intralesional corticosteroid injections is a practical and well-tolerated modality.
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Affiliation(s)
- Su Jung Park
- Department of Dermatology, Soonchunhyang University College of Medicine, Cheonan, South Korea
| | - Sun Hye Shin
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Young Gue Koh
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Gun-Ho Kim
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Nark Kyoung Rho
- Leaders Aesthetic Laser & Cosmetic Surgery Center, Seoul, South Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
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Wang QQ, Liu ZX, Wang P, Liu BY, Feng YP, Zhang Y, He HB, Yin T, Tang X, Wang YJ, Gou JX. Intratumoral injection of norcantharidin liposome emulsion hybrid delivery system amplifies the cancer-fighting effects of oral sorafenib against hepatocellular carcinoma. Colloids Surf B Biointerfaces 2023; 232:113599. [PMID: 37857183 DOI: 10.1016/j.colsurfb.2023.113599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/14/2023] [Indexed: 10/21/2023]
Abstract
Interventional therapies are increasingly used in clinical trials for hepatocellular carcinoma (HCC). Sorafenib is the front-line remedy for HCC, however, chemoresistance occurs immutably and affects the effectiveness of treatment. In a previous study, a norcantharidin liposome emulsion hybrid (NLEH) delivery system for HCC was developed. This study aims to examine the therapeutic effects of the combination of intratumoral injection of NLEH and sorafenib in treating HCC. Sorafenib combined with NLEH activated the apoptosis pathway by synergistically upregulating caspase-9, promoting cytotoxicity, apoptosis (64.57%), and G2/M cell cycle arrest (48.96%). Norcantharidin could alleviate sorafenib resistance by counteracting sorafenib-induced phosphorylation of Akt. Additionally, intratumoral injection of NLEH exhibited a sustained accumulation in the tumor within 24 h and didn't distribute to other major organs. Intratumoral injection of NLEH in combination with oral sorafenib displayed the most potent tumor growth inhibitory effect (77.91%) in vivo. H&E staining results and the indicators of the renal and liver function tests demonstrated the safety of this combination therapy. Overall, these results showed that intratumoral injection of NLEH in combination with oral sorafenib treatment represented a rational potential therapeutic option for HCC.
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Affiliation(s)
- Qing-Qing Wang
- School of Pharmaceutics Science, Shenyang Pharmaceutical University, Shenyang, Liaoning, China
| | - Zi-Xu Liu
- School of Pharmaceutics Science, Shenyang Pharmaceutical University, Shenyang, Liaoning, China
| | - Ping Wang
- Department of Pharmaceutics, College of Pharmacy Sciences, Jilin University, Changchun, Jilin, China
| | - Bo-Yuan Liu
- School of Pharmaceutics Science, Shenyang Pharmaceutical University, Shenyang, Liaoning, China
| | - Yu-Peng Feng
- School of Pharmaceutics Science, Shenyang Pharmaceutical University, Shenyang, Liaoning, China
| | - Yu Zhang
- School of Pharmaceutics Science, Shenyang Pharmaceutical University, Shenyang, Liaoning, China
| | - Hai-Bing He
- School of Pharmaceutics Science, Shenyang Pharmaceutical University, Shenyang, Liaoning, China
| | - Tian Yin
- Department of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang, Liaoning, China
| | - Xing Tang
- School of Pharmaceutics Science, Shenyang Pharmaceutical University, Shenyang, Liaoning, China.
| | - Yan-Jiao Wang
- School of Pharmaceutics Science, Shenyang Pharmaceutical University, Shenyang, Liaoning, China.
| | - Jing-Xin Gou
- School of Pharmaceutics Science, Shenyang Pharmaceutical University, Shenyang, Liaoning, China.
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Chang YH, Hung KS, Hsu CK. The tunneling technique of intralesional 5-fluorouracil in combination with triamcinolone injection for intractable keloids. Int J Dermatol 2023; 62:1551-1552. [PMID: 37772660 DOI: 10.1111/ijd.16863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/13/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023]
Affiliation(s)
- Yi-Han Chang
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Education Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Research Center of Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
| | - Kuo-Shu Hung
- Division of Plastic and Reconstructive Surgery and the Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Chao-Kai Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Research Center of Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Fawzy M, Nofal E, Abdelkhalek N, Ehab R. Intralesional bivalent and quadrivalent human papillomavirus vaccines didn't significantly enhance the response of multiple anogenital warts when co-administered with intralesional Candida antigen immunotherapy. A randomized controlled trial. Arch Dermatol Res 2023; 315:2813-2823. [PMID: 37573268 PMCID: PMC10615931 DOI: 10.1007/s00403-023-02698-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/08/2023] [Accepted: 08/02/2023] [Indexed: 08/14/2023]
Abstract
Treatment of anogenital warts (AGWs) is challenging. Candida antigen immunotherapy has been proven to be a safe and relatively effective therapeutic modality; nevertheless, some patients may experience a partial or no response. Combining Candida antigen with other immunotherapies has been proposed to improve the cure rate. Immunotherapy with human papillomavirus (HPV) vaccines has been tried with conflicting outcomes. This study aimed to assess the efficacy and safety of intralesional Candida antigen, either alone or in combination with intralesional bivalent or quadrivalent HPV vaccines, for treating multiple AGWs. Eighty patients with multiple AGWs were included and randomly assigned to four equal groups: group A treated with intralesional Candida antigen only; group B treated with intralesional bivalent HPV vaccine (Cervarix) and Candida; group C treated with intralesional quadrivalent HPV vaccine (Gardasil) and Candida; and group D (control) treated with intralesional saline. Complete clearance of lesions was detected in 40%, 20%, and 60% of patients in Candida monotherapy, Cervarix/Candida, and Gardasil/Candida groups, respectively, whereas 40%, 60%, and 20% of patients in the three groups, respectively, showed partial response. Only 10% of the control group had a partial response. Therapeutic outcomes were significantly better in the three treatment groups compared to the control group, with no statistically significant difference between the Candida monotherapy group and the combination groups, but the response was significantly better in the Gardasil/Candida group than in the Cervarix/Candida group. No statistically significant difference was found between the studied groups regarding the development of side effects. Moreover, no recurrence was detected in any of the groups throughout the 3-month follow-up period. Based on our results, combining intralesional HPV vaccines with Candida antigen immunotherapy may have no significant benefit for treating multiple AGWs. Candida antigen may be recommended as a relatively effective and inexpensive therapeutic modality. The combination of Gardasil and Candida was also effective but very expensive. The results of the Cervarix/Candida combination were unsatisfactory. This clinical trial was registered and approved prospectively by the ethical review board at Faculty of Medicine, Zagazig University.
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Affiliation(s)
- Manal Fawzy
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Eman Nofal
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Naglaa Abdelkhalek
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rana Ehab
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Langlie JA, Pasick LJ, Rosow DE. Cost-Effectiveness of Steroids for Prolonging the Surgery-Free Interval in Subglottic Stenosis. Laryngoscope 2023; 133:3436-3442. [PMID: 37278490 DOI: 10.1002/lary.30800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/15/2023] [Accepted: 05/20/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Repeat endoscopic dilation (ED) in the operating room for subglottic stenosis (SGS) remains an economic burden to patients. The cost-effectiveness (CE) of adjuvant serial intralesional steroid injections (SILSI) to prolong the surgery-free interval (SFI) in SGS patients requiring ED has yet to be studied. METHODS Details of the cost of SILSI and ED were received from our tertiary academic center. SFI, cost of intervention, and the effect of SILSI on prolonging SFI were collected from a systematic review by Luke et al. SGS etiologies in the review included idiopathic, iatrogenic, or autoimmune. A break-even analysis, comparing the cost of SILSI alone with the cost of repeat ED, was performed to determine if SILSI injections were cost-effective in prolonging the SFI. RESULTS Average extension of the SFI with SILSI was an additional 219.3 days compared to ED alone based on a systematic review of the literature. 41/55 (74.5%) cases did not require further ED once in-office SILSI management began. SILSI administered in a 4-dose series in 3-to-7-week intervals (~$7,564.00) is CE if the reported recurrence rate of SGS requiring ED (~$39,429.00) has an absolute risk reduction (ARR) of at least 19.18% with the use of SILSI. Based on the literature, SILSI prevents ~3 out of every 4 cases of SGS at sufficient follow-up from undergoing repeat ED, resulting in an ARR of ~75%. CONCLUSIONS SILSI is economically reasonable if it prolongs the SFI of at least one case of recurrence out of 5. SILSI, therefore, can be CE in extending the interval for surgical ED. LEVEL OF EVIDENCE NA Laryngoscope, 133:3436-3442, 2023.
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Affiliation(s)
- Jake A Langlie
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Luke J Pasick
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - David E Rosow
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
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