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Results for “Injections, Intralesional”

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PubMed1997

Surgical debridement and intralesional steroid injection in the treatment of idiopathic AIDS-related anal ulcerations.

BACKGROUND: The treatment of idiopathic anal ulcerations in AIDS patients is still evolving. These patients suffer with severe incapacitating anal pain. PATIENTS AND METHODS: Relief of pain was achieved with the use of intralesional steroid injections. Twenty-one patients from 1990 to 1993 presented with severe anal pain of 4.5 months average durations (range 3 weeks to 2 years). The average CD4 count was 52.1 (range 0 to 150). Fourteen (67%) patients had a solitary ulcer, while 7 (33%) had complex ulcerations. RESULTS: All patients were treated by debridement of the ulcer, biopsy, and intralesional injection of steroids. Microscopic evaluation revealed nonspecific inflammatory changes, without histopathologic evidence of viral infection or malignancy. Viral tissue cultures were negative. Fifty-seven percent of patients required only one injection to achieve dramatic relief of pain. Forty-three percent necessitated additional injections at 2-week intervals. The average patient was injected 1.9 times (range 1 to 7), with 20 of 21 patients (95%) reporting good to excellent pain relief. CONCLUSION: AIDS anal ulcerations should be treated aggressively with surgical debridement, biopsy and intralesional steroids. The efficacy of this therapy suggests that symptoms are partially due to inflammatory mediators.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Intralesional steroid injection in benign esophageal strictures resistant to bougie dilation.

OBJECTIVE: Some benign esophageal strictures are highly resistant to bougie dilation. The aim of this study was to determine whether intralesional steroid injection had additional benefit to Savary-Gilliard's bougie dilation therapy (SGBD). METHODS: Twenty-one patients were treated with a bougie dilator. The patients were randomized into control and study groups. There were 11 patients in the control group (7 males, 4 females; mean age 45.09 +/- 24.64 years) and 10 patients in the study group (4 males, 6 females; mean age 49.40 +/- 16.49 years). The patients in the control group underwent only SGBD, but patients in the study group received an additional intralesional steroid injection (8 mg triamcinolone acetate into each quadrant). The number of dilations was divided by the follow-up period (in months) to determine the periodic dilatation index. RESULTS: There was no difference in age, sex, etiology, localization and recurrence of lesions, treatment outcome, complications and the number of dilations between the study and control groups. In the study group, the mean periodic dilatation index was 0.712 (range 0.097-2.75) and 0.289 (range 0-1) before and after injections, respectively (P = 0.03). Additionally, the mean number of dilations was 5.3 (range 2-11) and 1.6 (range 0-5) before and after injections, respectively (P = 0.03). The mean symptom-free interval was 24 +/- 12.75 months in the study group and 5.18 +/- 5.06 months in the control group (P < 0.001). The total periodic dilatation index was 0.193 +/- 0.123 in the study group, while it was 0.597 +/- 0.583 in the control group (P < 0.05). CONCLUSIONS: It can be concluded that intralesional steroid injections increase efficacy of bougie dilation and decrease the requirement for repetition of bougie dilatation.

Adult↗

PubMedDate not supplied

Infantile subglottic hemangioma treated by intralesional steroid injection: report of one case.

Infantile subglottic hemangioma is a rare, life threatening disease of the larynx. Various treatments have been described in the literature, including tracheostomy, systemic steroids, intralesional steroid injection, carbon dioxide laser therapy, and interferon alfa-2a. The best treatment, however, remains controversial. We report a case of congenital subglottic hemangioma successfully managed with a single intralesional steroid injection, which resulted in rapid involution of the hemangioma without recurrence after 18 months of follow up. This therapy appears to minimize both short and long term morbidity associated with treatment of this lesion.

Adrenal Cortex Hormones↗

PubMed2000

Clinical update on 10 children treated with intralesional cidofovir injections for severe recurrent respiratory papillomatosis.

OBJECTIVES: To continue assessment of the benefits and risks of intralesional administration of cidofovir, an acyclic nucleoside phosphonate, for treating severe recurrent respiratory papillomatosis (RRP) in pediatric patients, and to discuss guidelines for larger prospective multi-institutional studies of the use of cidofovir. DESIGN: Prospective case series. SETTING: Tertiary care children's hospital. PATIENTS: A total of 10 patients with severe RRP (defined as requiring debulking procedures to maintain airway patency at least once a month) underwent intralesional cidofovir therapy. The original 5 patients have received more than 1 year of follow-up since their last cidofovir injection, and 5 subsequent patients have been treated with a revised injection protocol. INTERVENTION: Microsuspension laryngoscopy with intralesional injection of cidofovir after repetitive carbon dioxide laser treatments and mechanical debulking of papillomas. MAIN OUTCOME MEASURES: Papilloma stage at the time of serial laryngoscopies. Histologic examination of biopsy specimens of laryngeal tissue obtained 1 year or more after last cidofovir injection. RESULTS: There was evidence of marked improvement in the 4 of the 5 new patients enrolled under the revised injection protocol, continuation of a disease-free state in 1 of the original 5 patients, and sustained improvement in 4 of the 5 original patients, resulting in a significantly reduced interval of intervention. CONCLUSIONS: Intralesional cidofovir therapy continues to show benefit in the treatment of severe RRP in pediatric patients. Safety profiles have not been fully established, but current histologic data are reassuring.

Antiviral Agents↗

PubMed1988

Linear atrophy following intralesional steroid injections.

Two cases of perilymphatic atrophy following correctly administered intralesional steroid injections are reported. Perilymphatic atrophy produces a distinct clinical picture and may persist for months. A review of the literature shows that no treatment is indicated. It is stressed that the appearance of this cosmetically disturbing side effect is unpredictable, but spontaneously reversible.

Adolescent↗

PubMed2002

[Interventions for nasal hemangiomas in children].

OBJECTIVE: To explore an ideal therapy for nasal hemangiomas in children. METHODS: From June 1998 to April 2001, 110 patients with nasal hemangiomas in children were treated. Of them, 76 cases received Pingyangmycin intralesional injection (group I); 11 cases received steroids injection (group II); 7 cases received intralesional injection of absolute ethanol (group III); 6 cases received cryotherapy (group IV) and 10 cases with tumor resection (group V). RESULTS: In group I, II, III, IV and V, the cure rates were 88.16%, 27.27%, 100%, 50% and 80%, respectively. The satisfactory rates of the nasal contour after treatment were 86.84%, 18.18%, 0,0% and 10.00%, respectively. CONCLUSION: The nose is a special portion of the body with fine configuration. Once destroyed, it is difficult to restore. Therefore, it is necessary to adopt an effective therapy in the earlier stage. It is not advocated to wait for spontaneous involution. Intralesional injection of Pingyangmycin is an effective method in the treatment of nasal hemangiomas in children; Its result is exact, without significant side effects. The nasal appearance remains good after treatment.

English Abstract↗

PubMed2001

[Treatment of eyelid hemangioma in children with intralesional steroid injection].

Infantile hemangiomas affect about 5% (3-10%) of the population, showing a predilection for the face. Infants with hemangiomas of the eyelid are at risk amblyopia and strabismus. This is also a cosmetic defect. Several methods of treating these tumors have been associated with many complications. The use of intralesional steroid injections seems to be a simple, safe and effective method of treating hemangiomas of the eyelid in children.

Adolescent↗

PubMed1994

Intralesional corticosteroid injection with short-term oral prednisolone for infantile hemangiomas of the eyelid and orbit.

Infants with hemangiomas of the eyelid and orbit are at risk for amblyopia and refractive errors. Several methods of treatment for these tumors have been associated with complications and limitations. Five infants with these hemangiomas were treated by intralesional corticosteroid injection combined with short-term oral prednisolone. In an attempt to eliminate complications, corticosteroid injections were administered. In the cases of orbital hemangioma, ultrasonography guidance was used to assist the injection. This treatment is safe, simple, and effective for infants. In addition, complications are minimized.

Administration, Oral↗

PubMed2001

Preclinical targeted alpha therapy for subcutaneous melanoma.

An alpha-emitting immunoconjugate (AIC) against malignant melanoma was prepared from the radioisotope bismuth-213 and a melanoma monoclonal antibody, and was used to control the growth of subcutaneous melanoma in a nude mouse model. Activity tolerances were found to be 8 mCi/kg for intraperitoneal injection of the conjugate, and 10 mCi/kg for intralesional injections. Local targeted alpha therapy (TAT) via intralesional injections of activities in the range 12.5-200 microCi shows a very high level of inhibition of tumorigenesis and regression of tumours. Results show that isolated cancer cells and preangiogenic cell clusters can be eliminated by local TAT, and that intralesional injections of 100 microCi of AIC are sufficient to cause complete regression of melanomas with volumes up to 300 mm3 without any observed side effects. Systemic TAT was less effective, with all tumours experiencing growth delay and limited inhibition of tumour growth. These data provide the basis for clinical trials of TAT in recurrent subcutaneous melanoma.

Animals↗

PubMedDate not supplied

Retrospective evaluation of postoperative intralesional steroid injections on wound healing.

Steroids have been implicated as an etiology in delayed wound healing. Although there is much documentation in the literature that steroids delay wound healing, most studies are in vitro or use high systemic doses. No studies have used a one-time, postoperative, intralesional steroid injection and evaluated wound healing. This study retrospectively reviewed 73 patients with 115 foot and ankle surgeries over 12 years. Seventy-two patients had steroid injections and 43 did not. The average healing time for the steroid group was 17.1 +/- 10.5 days, and for the non-steroid group 17.3 +/- 8.75 days. There were two infections in the non-steroid group, and one infection in the steroid group. There were five dehiscences in each group. The patients were further subdivided into groups based on age, gender, number of procedures, type of surgery, health status, steroid type, and steroid dose. The healing time increased in patients > 60 years old, and in immunocompromised patients. The patients who had more complex surgery had increased healing time. The males had a longer healing time than the females. Overall, there was not a statistically significant difference between the steroid groups and the non-steroid group. Therefore, one-time postoperative intralesional steroid injections were not found to delay wound healing.

Adult↗

PubMedDate not supplied

Intralesional corticosteroid injection for central giant cell granuloma: a case report and review of the literature.

Central giant cell granuloma (CGCG) is a benign intraosseous lesion of the jaws that is found predominantly in children and young adults. Although benign, it may be locally aggressive, causing extensive bone destruction, tooth displacement and root resorption. The common therapy is aggressive curettage, peripheral ostectomy or resection, which may be associated with loss of teeth and, in younger patients, loss of dental germs. A number of alternative nonsurgical approaches have been advocated in recent years for the management of CGCGs. These include intralesional corticosteroid injections, calcitonin injections and subcutaneous alpha-interferon injections. In this article, an 1-year-old boy with a CGCG is successfully treated with corticosteroid injections and this treatment is discussed within a review of the literature.

Adrenal Cortex Hormones↗

PubMed2005

The outcome after cryosurgery and intralesional steroid injection in vulvar lichen sclerosus corresponds to preoperative histopathological findings.

BACKGROUND: Vulvar lichen sclerosus (LS) still presents a therapeutic challenge. QUESTIONS: The aim of the present study was to investigate whether there is a correlation between preoperative histopathological findings in female LS and long-term results after cryosurgery and intralesional steroid injections. MATERIAL AND METHODS: 22 females with LS, mean age 65.3 +/- 10.5 years, were treated with cryosurgery (-186 degrees C) using the contact method with 1 freeze-thaw cycle per lesion and intralesional triamcinolone acetonide injection. The time between surgery and follow-up examination was 27.8 +/- 14.6 months. We compared the clinical outcome and the thickness of the epidermis, the zone of sclerosis and the inflammatory infiltrate in biopsy specimens taken before treatment. RESULTS: In 14 of 22 patients, a relapse after cryosurgery occurred (median after 7.5 months). Patients would 'moderately' recommend cryosurgery for LS (2.2 +/- 0.9; minimum: 0, optimum: 4). Pruritus was significantly reduced (visual analog scale: preoperative 7.1 +/- 2.6 vs. postoperative 2.0 +/- 2.4; p = 0.001) even in patients with relapse (preoperative 7.6 +/- 2.4 vs. postoperative 3.1 +/- 2.28; p = 0.001). Women with relapse showed a significantly higher composed thickness of epidermis, sclerosis and inflammatory infiltrate (430 +/- 139.0 microm) than those without relapse (314 +/- 41.2 microm; p = 0.046). CONCLUSION: In our patients, cryosurgery and intralesional steroid injections were efficient in the treatment of LS. Patients showing relapse had a thicker epidermis and a stronger inflammatory infiltrate. Therefore a treatment of LS should be performed at an early stage of the disease.

Adult↗

PubMedDate not supplied

Combination of surgery and intralesional verapamil injection in the treatment of the keloid.

Keloid scars are one of the most challenging problems for physicians and surgeons. These scars have been treated in many ways, with varying success. Verapamil is a widely used calcium channel antagonist, and it has been shown that calcium channel blockers inhibit the synthesis/secretion of extracellular matrix molecules, including collagen, glycosaminoglycans, and fibronectin, and increase collagenase. In this study, we performed total keloid excision in combination with reconstruction with W-plasty or skin grafting and injection of verapamil hydrochloride into the lesions of 21 patients with keloids. Patients were followed for minimum of 2 years, and the treatment outcome was evaluated based on the cosmetic appearances, symptomatic improvements, and the results of microscopic examinations. Also, patient satisfaction was scored with a visual analog scale. Two years after the operations, two patients had keloid in lesser diameter than the original lesions, two patients had lesions that were hypertrophic scars in appearance, and four patients had pruritus. One patient had keloid on the donor site. The rate of patient satisfaction was 6.4 on a scale of 1 to 10. We reviewed the treatment of keloid in this study and obtained one of the lower rates of complication in the literature. We believe that surgical excision with W-plasty or skin grafting and intralesional verapamil injection may be a good alternative in the treatment of keloid.

Adolescent↗

PubMedDate not supplied

Cheilitis granulomatosa of Melkersson-Rosenthal syndrome: treatment with intralesional corticosteroid injections.

BACKGROUND: Melkersson-Rosenthal syndrome may manifest as the classical triad (orofacial edema, facial nerve palsy and stable lingua plicata) but monosymptomatic manifestations or combinations of typical symptoms are not infrequent. The available therapeutic options provide only limited success or temporary benefit. CASE REPORT: A 20-year-old man presented with a 7-month history of recurrent episodes of swelling of the upper lip without pain, burning or local pruritus. No causative factors, such as food, drugs or latex, or physical, chemical or emotional conditions could be identified. The patient had been treated with oral antihistamines and corticosteroids with no clinical improvement. Physical examination showed firm edema without fovea, limited to the central area of the upper lip without epidermal changes or symptoms on palpation. The patient had a previous history of facial palsy 6 years previously and recurrent episodes of herpes simplex labialis. Skin prick tests with inhalant aeroallergens, food, latex and Anisakis allergens were negative. Laboratory investigation revealed normal complete blood count, erythrocyte sedimentation rate, thyroid hormones, biochemistry, complement components (C3, C4 and C1-esterase inhibitor) and CH50, rheumatoid factor, antinuclear antibodies, immune complexes, protein electrophoresis and immunoglobulins. Thorax and paranasal sinus radiographs were clear. Biopsy of the involved area of the lip showed edema with lymphocytic and plasma cell infiltration and mononuclear perivascular infiltrates without granulomas, suggesting initial granulomatous cheilitis. Because the patient showed lack of response and/or poor tolerance to prior treatments (deflazacort, clofazimine and metronidazole), intralesional triamcinolone injections were administered with satisfactory response from the first session. CONCLUSIONS: Response to available treatments for Melkersson-Rosenthal syndrome is highly variable. In the present case, intralesional triamcinolone injections were effective.

Adult↗

PubMed1994

Treatment of aphthous ulcers in AIDS patients.

From 1987 to 1992, 240 acquired immunodeficiency syndrome (AIDS) patients with oral, laryngeal, and pharyngeal ulcers were evaluated. In 180 patients, ulcers resolved in less than 2 weeks without treatment. Of the 60 patients whose ulcers persisted for more than 2 weeks, 24 were culture positive for herpes simplex virus, Cryptococcus organisms, cytomegalovirus, or Mycobacterium organisms and were treated accordingly. The remaining 36 patients were diagnosed as having major aphthous ulcers. The usual sites for these ulcers were the floor of the mouth, tonsillar fossa, and epiglottis. The most common symptoms were pain and weight loss. The patients were treated with intralesional injection with triamcinolone acetonide and examined weekly. Ulcers were reinjected biweekly as needed. Response to treatment was evaluated by pain relief, ulcer healing, and weight gain. All patients reported pain relief within 2 days of initial injection. Most had marked reduction in ulcer size and subsequent weight gain, and many experienced total resolution of symptoms and complete healing.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Intralesional interferon in basal cell carcinoma: how does it work?

Basal cell carcinoma (BCC) is the most common skin cancer among Caucasians, and its incidence is increasing. Intralesional injection of interferon alpha (IFN alpha) has been shown to provide a safe and effective treatment for BCCs. The predominant mechanism for the effect of IFN alpha on BCC has been partially identified. We have shown that in untreated patients, BCC cells constitutively express CD95 ligand (CD95L), but not the receptor. BCC cells make use of the CD95 ligand to escape from a local immune response by averting the attack from activated CD95 receptor-positive CD4+ T cells. The CD95L of BCC cells is functional as CD95+ target cells incubated on BCC cryosections become apoptotic and are lysed. In IFN alpha-treated patients BCC cells express not only CD95L but also CD95 receptor, and regress by committing suicide or fratricide through apoptosis induction via CD95 receptor-CD95L interaction. Peritumoral infiltrating cells, predominantly CD4+ T cells, may support regression of BCC by the secretion of cytokines such as IFN gamma or interleukin-2 which may also be responsible for the up-regulation of CD95 on BCC cells.

Basal Cell Carcinoma↗

PubMed1995

Perspectives of cytokine treatment in malignant skin tumors.

Cytokines have been tested in the treatment of different skin cancers during the last decade, and treatment schedules have been established or proposed for several malignant skin tumors. Preferentially, the interferons and interleukin-2 were found to be effective in treating skin cancers. Interferons alpha and beta have been approved for the treatment of human immunodeficiency virus (HIV)-associated Kaposi's sarcoma, cutaneous T cell lymphoma, and malignant melanoma in several countries. Interferon alpha was found to be most effective in cutaneous T cell lymphoma with 40%-60% overall responses. When combining interferon alpha with psoralens and ultraviolet A (PUVA) or with retinoids, even higher response rates up to 60%-90% were reported, and long-term remissions have been described. A considerable activity of interferon alpha was found in HIV-associated Kaposi's sarcoma with response rates of 30%-50%. The effectiveness of Kaposi's sarcoma's treatment was further improved by combining interferon alpha and zidovudine. Responses to interferon alpha in metastatic malignant melanoma are rather seldom (10%-15%), but a stabilization of the disease with prolonged survival was reported after interferon alpha treatment. Additionally, interleukin-2 was found to be active in metastatic melanoma, with overall response rates of about 20%, and both biological agents were found to have an additive efficacy in combination. Several combined regimens of interferon alpha, interleukin-2, and polychemotherapy have been described in metastatic melanoma, and overall response rates higher than 50% were found with these combined treatment modalities. Interferon alpha and beta were also intralesionally injected into basal cell carcinomas and other epithelial skin cancers, and complete responses were found in more than 80% of tumors treated. Local applications of interferons and interleukin-2 were likewise found to be effective in the treatment of cutaneous melanoma metastases and cutaneous manifestations of Kaposi's sarcoma. Cytokines and their combination with other treatment modalities has greatly enriched the treatment facilities in malignant skin tumors during recent years, and additional new cytokines will be introduced in skin cancer treatment in near future.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Efficacy of bleomycin treatment for symptomatic hemangiomas in children.

Five children aged 5-19 years had pain in massive, inoperable hemangiomas. They were treated with intralesional injections of 2 mg bleomycin as a 0.4 mg/ml solution in the painful area. The injections were repeated after 4 -6 weeks for a total of 6 -10 times. All children were relieved of pain, and the swelling was reduced in all cases. There were no complications or side effects. Bleomycin therapy of painful, massive hemangiomas can be recommended in older children.

Adolescent↗