Intralesional Corticosteroid Injection Research Articles

12712 Use of local anesthetic for intralesional corticosteroid injections: A double-blinded randomized controlled trial

Background: Corticosteroid injections are commonly used to treat a variety of inflammatory dermatologic conditions. Standard practice entails administering corticosteroids sometimes mixed with a local anesthetic, typically lidocaine with epinephrine. Owing to an acidic pH, local anesthetics cause a burning sensation during infiltration and this may be a significant component of associated injection pain. The goal of this study is to determine if removing lidocaine from intralesional steroid injections changes pain outcomes.

REFRACTORY RELAPSING POLYCHONDRITIS: WHAT SHOULD A PULMONOLOGIST DO?

SESSION TITLE: Fellows Pulmonary Manifestations of Systemic Disease Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: October 18-21, 2020 INTRODUCTION: Relapsing polychondritis (RP) is a rare systemic disease characterized by recurrent episodes of inflammation, which can result in degeneration and deformation of the cartilage of the ears, nose, larynx, and tracheobronchial tree. The incidence of RP is 0.7-4.5 per million people with a 20-50% prevalence of respiratory impairment. Airway involvement portends a poor prognosis in this disease, and reporting of cases is beneficial to educate pulmonologists about the importance of a multidisciplinary team in managing patients with RP. CASE PRESENTATION: A 23-year-old female with relapsing polychondritis, subglottic stenosis, and tracheal stenosis status post tracheostomy on chronic immunosuppression with dapsone, mycophenolate, and prednisone presented with worsening shortness of breath despite steroid injections for subglottic stenosis. CT chest demonstrated tracheal narrowing with significant wall thickening of the bilateral mainstem bronchi. She underwent bronchoscopy, which demonstrated erythema in the trachea with loss of the cartilaginous rings, mucosal thickening extending to the bilateral mainstem bronchi including LC2 and RC1, and normal distal bronchi. Even with PEEP, she had complete collapse of the bilateral mainstem bronchi with expiration. Her prednisone dose was increased, but her shortness of breath persisted. Her FEV1 was 46% predicted and FEV1/FVC was 49% predicted on pulmonary function testing. Due to worsening dyspnea at rest, she underwent repeat bronchoscopy 3 months later which demonstrated slightly worsening of inflammation in her mainstem bronchi. She was started on Actemra by rheumatology with subjective improvement in her shortness of breath within 3 weeks. Polysomnography was ordered to try to qualify her for nocturnal non-invasive ventilation. After discussion with otolaryngology, it was decided to not pursue further bronchoscopy for airway evaluation due to concern that bronchoscopy would cause worsening of inflammation of her airways over time. DISCUSSION: Management of refractory RP is challenging for the pulmonologist because there are not evidence based guidelines to follow. Based on expert opinion, pulmonary function testing with flow volume loops is recommended in all patients with RP to characterize airway involvement in symptomatic patients. For the treatment of tracheomalacia, intralesional corticosteroid injections and tracheostomy can be warranted. Tracheobronchial stenting can be helpful, but it also risks worsening of airway inflammation. Thus, a team-based approach is helpful to weigh the risks and benefits of treatment options to determine the best care for the patient with worsening symptoms. CONCLUSIONS: Relapsing polychondritis is a rare disease which is challenging to treat due to a lack of evidence based guidelines. Leveraging the expertise of otolaryngology, pulmonology, and rheumatology is helpful to guide symptomatic management. Reference #1: Lekpa FK, Chevalier X. Refractory relapsing polychondritis: challenges and solutions. Open Access Rheumatol. 2018;10:1-11. Published 2018 Jan 9. doi:10.2147/OARRR.S142892 Reference #2: Ernst A, Rafeq S, Boiselle P, et al. Relapsing polychondritis and airway involvement. Chest. 2009;135(4):1024-1030. doi:10.1378/chest.08-1180 Reference #3: de Montmollin N, Dusser D, Lorut C, et al. Tracheobronchial involvement of relapsing polychondritis. Autoimmun Rev. 2019;18(9):102353. doi:10.1016/j.autrev.2019.102353 DISCLOSURES: No relevant relationships by Maureen McElligott, source=Web Response

CONSERVATIVE MANAGEMENT OF CENTRAL GIANT CELL LESION OF THE JAW: A CASE REPORT

Central giant cell lesion (CGCL) is an intra-osseous benign lesion composed of ovoid or spindle-shaped mononuclear cells interspersed by multinucleated giant cells in a high vascularized connective tissue stroma. CGCL is prevalent in the first and second decades of life. The clinical behavior may be indolent or extensively osteolytic. In this report we present a case of successful treatment using intralesional injections of corticosteroids. A 9-year-old boy presented with an extensive asymptomatic swelling in the right maxilla. Computed tomography showed an expansive, well-circumscribed, multiloculated, hypodense lesion in the right maxilla, maxillary sinus, and nasal cavity. The incisional biopsy confirmed the diagnosis of CGCL; 0.4 mL of triamcinolone hexacetonide 20 mg/mL diluted in 0.6 mL of 2% lidocaine (epinephrine 1:100.000) was administered on a weekly basis for 14 weeks. One year later, no tumor was observed, which was confirmed by a fine-needle aspiration biopsy. No recurrence was observed in 7 years’ of follow-up.

STEVENS-JOHNSON SYNDROME IN PATIENTS WITH HIV: A CHALLENGING TREATMENT

Stevens-Johnson Syndrome (SJS) is a severe mucocutaneous drug reaction characterized by epithelial detachment, painful erosions and ulcers on any mucosal body surface, and systemic symptoms. Patients with HIV are susceptible to many complications, including drug reactions. Patients with HIV with SJS present a worse prognosis and treatment challenges. A 46-year-old HIV-positive woman developed SJS after using amoxicillin-clavulanic acid (Clavulin (glaxosmithkline)), dipyrone, and azithromycin. The patient developed mucocutaneous ulcers, epithelial detachment, and ocular involvement. The oral lesions were successful treated with high potency topical corticosteroids, except for a large ulcer on the dorsal surface of the tongue. Debridement, application of hydrogen peroxide, chlorhexidine, and low-level laser therapy were used without success. Just after the administration of 18 intralesional corticosteroid injections, the lesion had complete remission. The patient is still under treatment for the ocular lesion. The aim of this report is to emphasize the challenge of SJS treatment in patients with HIV.

Intralesional injection of triamcinolone hexacetonide as an alternative treatment for central giant cell lesions: a prospective study.

The aim of this prospective study was to report on the response to treatment of central giant cell lesions (CGCL) with intralesional corticosteroid injections. Consecutive cases of CGCL were treated with a biweekly intralesional injection of 20mg/ml triamcinolone hexacetonide diluted in an anaesthetic solution of 2% lidocaine/epinephrine 1:200 000 at the proportion 1:1. All patients were monitored using cone beam computed tomography. Eleven patients were treated; their ages ranged from 15-34 (mean 22 years); and eight lesions were in the mandible, and three in the maxilla. Three cases were diagnosed as non-aggressive, and eight as aggressive. Six cases presented good results (four aggressive and two non-aggressive); three cases presented a moderate response (two aggressive and one non-aggressive); and two had a poor response to treatment (both aggressive). In four cases with a good response, osteoplasty was done. In all cases with a moderate response, the remaining lesion was curetted. Cases with a poor response were submitted to either curettage or denosumab injections. Corticotherapy, as main or neoadjuvant therapy, may be an option for treatment of CGCL.

Guiding principles for prioritization of limited in-person dermatology appointments during the COVID-19 pandemic

Guiding principles for prioritization of limited in-person dermatology appointments during the COVID-19 pandemic

Comparative study between fractional carbon dioxide laser vs intralesional steroid injection in treatment of alopecia areata.

Few studies have reported Fractional Carbon Dioxide (FCO2) laser use in treating alopecia areata (AA), yet, effectiveness of this therapy has not been comparatively analyzed. To assess efficacy and safety of FCO2 laser in comparison to traditional intralesional corticosteroids injection (ILCs) in treatment of AA. This study included 20 patients with at least two patches of AA. Patients were subjected to history taking, general, dermatological and folliscopic examination. One patch was treated by FCO2 laser every 2 weeks for 3 to 6 sessions, while the other treated with intradermal injection of Triamcinolone Acetonide monthly for three sessions maximally. Evaluation of treatment response was done by physician clinical assessment using Mean Improvement Score (MISP), patient satisfaction and folliscopic examination measuring hair density (hair/cm2 ) before each session, 1 month and 3 months after end of sessions. The obtained data were tabulated and statistically analyzed. There was a highly significant improvement with FCO2 laser rather than ILCs 3 months after last session according to MISP, patient satisfaction and hair density without serious side effects or relapse. FCO2 laser could be a better therapeutic alternative for treating AA in comparison to traditional ILCs.

Laser‐assisted topical steroid application versus steroid injection for treating keloids: A split side study

Approaches to improve keloid scars include intralesional corticosteroid injections and fractional lasers exclusively. The combinative use of ablative fractional laser therapy and occluded topical corticosteroid as a drug delivery method enhances therapeutic outcome of two efficient scar therapy modules into one simple synergistic module. To compare the therapeutic effect of combining two modalities of scar treatment, the first is fractional ablative laser treatment and the other is occluded topical corticosteroid to the standard use of intralesional steroid injection. Keloids from thirty suffering patients were split faced into two identical parts; one part received an intralesional corticosteroid injection while the other part was treated first with fractional ablative 2940nm Er: YAG laser followed by occluded topical application of steroid cream. Four treatment sessions were performed with 4-week interval between sessions. Every session was assessed photographically and using the Vancouver Scar Scale (VSS). The mean keloid VSS before treatment was 6.9±1.9. After treatment, the mean keloid VSS of the injection side became 2.63±2.09, and mean keloid VSS of the laser-treated side became 2.07±2.02. Each of the treated halves showed a statistically significant improvement in their VSS. However, no statistically significant differences were observed for either of the treated halves over the other one. Although intralesional steroids injection is the standard procedure for treatment of keloid scars, the use of ablative fractional laser-assisted delivery of topical steroid can offer a safer and a better aesthetic treatment option.

Clinical effect of Zhang's super tension-relieving suture for high-tension wound closure

Objective: To investigate the clinical effect of Zhang's super tension-relieving suture applied in high-tension wound closure. Methods: From January to August 2019, 19 eligible patients with scar or black hairy nevus were treated with Zhang's super tension-relieving suture for outpatient operation in the Department of Plastic and Reconstructive Surgery of Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. The patients were composed of 6 males and 13 females, aged 10-68 years, with 8 keloids, 3 hypertrophic scars, 5 atrophic scars, and 3 black hairy nevus. The operation sites included lower jaw in 2 cases, neck in 3 cases, chest in 4 cases, abdomen in 2 cases, and limbs in 8 cases. The size of scars and black hairy nevus before surgery ranged from 1.4 cm×1.1 cm to 10.0 cm×4.0 cm. All the lesions underwent excision alone with both sides of the incision undermined for 1 to 2 cm, and the wound size ranged from 2.6 cm×2.6 cm to 12.6 cm×6.8 cm. Zhang's super tension-relieving suture was applied with barbed suture, and the wound edges were naturally jointed with relaxation and low tension by pushing normal skin on both sides to the middle. Two patients with keloids underwent superficial radiotherapy within 24-hour interval after the surgery, with a total of 20 Gy delivered in 4 times, once a day. All the patients were followed up at outpatient clinics, with tension-relieving duration and adverse effects recorded. Six months after operation, the Vancouver Scar Scale (VSS) was used to evaluate scar appearance, while scar width and recurrence were recorded. Results: All the wounds of 19 patients healed completely after surgeries. Two patients experienced transient hyperpigmentation at puncture points and recovered without intervention, and one of them had hypertrophic scar at the puncture point, which was relieved after intralesional injections of corticosteroids. One patient underwent transient erythema, dry desquamation, and hyperpigmentation after radiotherapy, which recovered without intervention. Follow-up time ranged from 7.1 to 13.6 months, with an average of 9.6 months. Tension-relieving duration ranged from 4 to 26 weeks, with an average of 11.2 weeks. Two patients underwent Zhang's super tension-relieving suture again 8 weeks after operation due to their short tension-relieving duration which lasted for only 4 weeks after the first suture. Six months after operation, liner scars were achieved in all the patients with an average width of 2.2 mm (0.8 to 7.0 mm) and an average VSS score of 2.1 points (1.0 to 4.3 points). Three keloid patients had local recurrence 3 months after surgery for not receiving radiotherapy, which was obviously relieved following laser treatment in combination with intralesional injections of corticosteroids and 5-fluorouracil, etc. Conclusions: Zhang's super tension-relieving suture technique with barbed suture is able to effectively relieve the tension on wound edges, extend the tension-relieving duration, and reduce the hypertrophic scar risk when applied in high-tension wound.

The infection rate of intralesional triamcinolone and the safety of compounding in dermatology for intradermal and subcutaneous injection: A retrospective medical record review

Intralesional injection of sterile medications remains a mainstay in dermatology, enabling a tailored, low-cost, in-office therapy. After the 2012 United States outbreak of fungal meningitis from contaminated intrathecally administered corticosteroids, there has been increased regulation of in-office compounding, regardless of the administration route. Studies demonstrating the safety data of in-office corticosteroid compounding for intradermal or subcutaneous use are lacking. To assess the incidence of infection caused by compounded in-office intralesional triamcinolone. A retrospective medical record review identified patients who received in-office intralesional corticosteroid injections in 2016. Medical documentation within 30days of injection was reviewed for suspected infection. The records of 4370 intralesional triamcinolone injections were assessed, of which 2780 (64%) were compounded triamcinolone with bacteriostatic saline. We identified 11 (0.25%) suspected localized infections, with 4 of the 11 in the compounding cohort. Of these, 7 of 11 occurred after injection of an "inflamed cyst." No hospitalizations or deaths occurred. No temporal or locational relationships were identified. This study was limited to 2 academic institutions. A 30-day postinjection time frame was used. In-office compounding for intralesional dermal and subcutaneous administration is safe whensterile products are used by medical practitioners. There is no increased risk of compounded triamcinolone relative to noncompounded triamcinolone.

CLINICAL EVALUATION OF USING BENZYDAMINE HYDROCHLORIDE ORAL GEL WITH INTRALESIONAL CORTICOSTEROID INJECTION FOR PAIN CONTROL IN SYMPTOMATIC ORAL LICHEN PLANUS

Introduction: Lichen planus is a chronic inflammatory immune-mediated disease affecting skin and mucous membrane. Oral lichen planus (OLP) appears clinically as symmetrically distributed rough white striations on a mild background erythema. Erosive and atrophic lesions characterized by causing sensitive sensation or pain ranging from episodic to severe discomfortable pain. Treatment of OLP is mainly by topical or systemic corticosteroids. Intralesional injection of corticosteroid was used for treatment of extensive or recalcitrant symptomatic OLP lesions. Various types of topical analgesics could be used in accompanied with corticosteroid therapy to decrease pain sensation in a safe way. Benzydamine Hydrochloride is used due to its anesthetic, analgesic, antimicrobial, and anti-inflammatory action as a topical non-steroidal agent. Materials and Methods: Twenty patients participated in this study having symptomatic bullous erosive OLP. In the first group, ten patients treated by intra-lesional corticosteroid injection alone. In the second group ten patients treated with intra-lesional corticosteroid injection accompanied with Benzydamine Hydrochloride oral gel. Results: A statistical significant difference exists between both groups regarding visual analog scale by the end of first and third week. Also by the end of third and fourth week statistical significant difference exists between both groups in grades of clinical improvement which was in favor of the combination therapy group. Conclusion: Benzydamine hydrochloride gel is considered a simple, safe, well tolerated and effective method to reduce the severity of symptomatic oral lichen planus.

Outcome of combined surgical and intralesional steroids injection therapy for management of ear keloid

Background: Ear keloid is one of the challenging problems that affect people of different races with substantial aesthetic outcomes. Various types of treatment modalities, including intralesional corticosteroid injection are advocated to lower recurrence following excision.
 Objectives: To investigate the efficacy of a combined excision and postoperative intralesional triamcinolone acetonide (TA) injection for treating ear keloid patients.
 Methodology: This was a descriptive study done to observe the outcome of combined approach of surgical and intra-lesional steroids injection therapy for ear keloids. Age, sex, site, size, duration, recurrence, and aesthetic outcome were evaluated.
 Results: A total of 18 patients representing 19 ear keloids, with one case having bilateral and 3 pediatric cases were included from February 2018 to January 2019.The mean age was 22 years with female to male ratio of 5:1, site were left sided 9 (50%), right 8 (44%) and 1(6%) bilateral. About 10 (53%) cases were at helix, and 9(47%) at ear lobule. Mean length of ear keloid was 1.53 cm with range of 0.5-3cm and mean breath 1.39cm with the range of 0.5-2.5 cm. The mean duration of ear keloid was 9.47 months. 2 (11%) cases showed a history of recurrence. Injection triamcinolone acetonide hypersensitivity was noted by 1 (5.3%) patient. Evaluation for all patients with aesthetic outcome was mean ± standard deviation (4.38±1.025).
 Conclusion: Management of ear keloid using the combination of surgical excision and intra-lesional steroids injection therapy can be a good alternative option with low recurrence rate.

Comparative Study on the Efficacy of Intralesional Minoxidil Injection Alone and in Combination versus the Standard Intralesional Corticosteroid Injection in the Treatment of Alopecia Areata

Abstract Background Alopecia areata (AA) is a common, inflammatory, non-scarring type of hair loss. Although hair loss can affect all hair bearing sites, patchy alopecia affecting the scalp is the most common type. Hair loss may progress to alopecia totalis (AT) which is complete balding at the scalp, or to alopecia universalis (AU), describing loss of all hairs on the scalp and body. Consequently, this can cause a devastating emotions effects on patients and may be expose them to psychological comorbidities such as depression, anxiety and social phobia. Objectives To assess the efficacy and safety of intradermal delivery of minoxidil 5% alone and in combination with intralesional triamcinolone acetonide for treatment of alopecia areata. Patients and Methods This study is prospective randomized intra-patients comparative control clinical trail that include 20 Egyptian patients suffering from multiple patches of AA during December 2017 till November 2018 which approved by The Dermatology Research Ethical Committee, Faculty of Medicine, Ain Shams University. Each patient had at least 5 scalp patches of approximately similar size (minimally 3 cm2) with a severity of alopecia tool (SALT) score up to S2 (less than 50% of scalp involvement) either in stable or progressive course. Patients were recruited from outpatient clinic of Dermatology, Ain Shams University Hospital and Al-houd Al-marsoud Hospital and informed written consent was obtained from all of them after explanations the study objective before enrollment in it. Results Considering the side effects of the treatment, all patients in all groups develop different types of side effects only the intolerable pain of injection was common between them and it was statistically not significant in comparison between the treatment groups. All the treatment groups showed significant reduction in dermoscopic finding of AA after treatment except in control group. Conclusion Standard intralesional corticosteroids are the mainstay first line treatment of patchy alopecia that involving less than 50% of the scalp and for cosmetics areas such as beard and eyebrows.

Intralesional corticosteroid injection as an effective treatment method for oral lesions: a meta-analysis

Intralesional corticosteroid injection (ICSI) is known as one of the main methods used for treating a wide range of lesions. It also results in a high concentration of drugs at lesion sites, with minimal systemic absorption. Thus, this study aimed to provide a review of the intralesional corticosteroid injection (ICSI) indications in the treatment of oral lesions. To this end; relevant key words were searched in the databases of PubMed, Google Scholar, Scopus, ScienceDirect, and UpToDate in the present study. Accordingly, the results of a total number of 62 case reports or case series articles were used in this study and the positive therapeutic effects of intralesional corticosteroid injection (ICSI) in 23 common oral lesions were reported. The most common type of intralesional steroid in the treatment of oral lesions was triamcinolone. No significant difference was also observed in terms of pain in patients following the use of steroid alone or in combination with anesthetic agents; moreover, the reported side effects of this method were exceptionally rare and transient. It was concluded that the intralesional corticosteroid injection (ICSI) could be one of the effective therapeutic methods with no significant problems in many oral lesions such as inflammatory, immunologic, and vascular ones due to its higher therapeutic effects than other topical forms of steroids and fewer side effects than systemic corticosteroid.

Intralesional corticosteroid injections for the treatment of oral lichen planus: A systematic review

Background: Oral lichen planus is a chronic, immune-mediated disease that can impact the oral cavity significantly. Treatment options include topical and systemic corticosteroid therapy based on the disease severity. Intra-lesional corticosteroid injections (ILCI) have been incorporated in clinical practice as an effective modality to deliver treatment locally to expedite the healing process while limiting systemic toxicity. Purpose: The objective of this systematic review was to evaluate the role of ILCI in treating OLP. Methods: A systematic review of the literature was conducted in the PubMed and Web of Science databases following PRISMA protocol and up to September 2019. All English-language literature on ILCI for OLP was included. Relevant articles were systematically reviewed using multiple levels of elimination by title, abstract, and full text. Data from the included studies were extracted and analyzed. A total of six studies met the inclusion criteria. Results: Triamcinolone acetonide intra-lesional injection demonstrated efficacy and rapid healing of OLP lesions in three studies. Minor adverse events of secondary oral candidiasis and cushingoid features were reported. Conclusion: ILCI may be considered as an effective treatment option for OLP lesions with minimal side effects and risk of disease relapse.

Hybrid ameloblastoma and central giant cell lesion: Challenge of early diagnosis

Hybrid lesions encompass the occurrence of different entities in one lesion. A 67-year-old woman was referred to the Oral and Maxillofacial Surgery Service for treatment of mandibular Central Giant Cell Lesion (CGCL) previously diagnosed. Intraoral examination revealed edentulism and a painless swelling extending from the alveolar ridge to the buccal vestibule with hard consistency covered by normal mucosae, with unknown duration. Panoramic radiograph revealed a large, multilocular and well-defined radiolucent lesion extending from the region of left mandibular lateral incisor teeth to right mandibular first molar with no evidence of osseous perforation. Initially, a treatment with intralesional injection of corticosteroids was performed. After 18 months of treatment, an increase in size of the osteolytic lesion was noted. An incisional biopsy was carried out and the microscopic examination revealed a unicystic ameloblastoma associated to CGCL. It was performed marsupialization and later the enucleation of residual lesion. The follow-up remains being performed. Key words:Hybrid lesion, central giant cell lesion, ameloblastoma.

Efficacy and Safety of Musculoskeletal Ultrasound Guided Aspiration and Intra-Lesional Corticosteroids Injection of Ruptured Baker's Cyst: A Retrospective Observational Study.

Objective:The aim of the work was to demonstrate the effectiveness and safety of ultrasonographic guided aspiration performed with corticosteroid injection intra-lesional for ruptured Baker cysts (BCs).Methods:Single-center retrospective study that included 42 patients with knee joint disorder associated with ruptured BCs were treated by ultrasonographic guided aspiration of fluid from the cyst and different points from the calf then intra-lesional injection of corticosteroids once or twice, 1 week apart. Follow up were done weekly until complete resolution of symptoms. Visual analog scale (VAS) and Rauschning-Lindgren and Lysholm Knee Scoring Scales (RLC) were used for assessment.Results:Clinical parameters (VAS and RLC) improved significantly in all patients at both post injection evaluation visits (1 week and 12 weeks). Ultrasonographic features improved significantly with complete disappearance of free fluid in the calf in 35 (83.3%) cases 1 week after the injection, and in 41 (97.6%) after 12 weeks. As regards BCs only 4 (9.5%) cases showed complete disappearance after 1 week and there was recurrent BCs in 38 (90.5%) cases which required reaspiration. While after 12 weeks, BCs were completely disappeared in 23 (54.8%) cases, most of the relapsed BCs were complex BCs. No side effects were reported in all cases.Conclusion:Ultrasonographic guided aspiration followed by injection of corticosteroids intra-lesional is an efficient and safe method for managing ruptured BCs.

A rare case of tumid lupus erythematosus with unilateral linear distribution in a young child

Tumid lupus erythematosus (TLE) as a rare variant of cutaneous lupus erythematosus (CLE) is characterized by edematous, urticarial-like annular papules and plaques. TLE has similar histopathologic findings to CLE such as periadnexal lymphocytic infiltration and interstitial mucin deposition. Although TLE develops on sun-exposed areas at any age, it is rarely distributed along the Blaschko lines and develops in infancy and childhood. Unlike CLE, skin lesion of TLE heals without leaving scarring or dyspigmentation. Here, we report a rare case of unilateral linear TLE in a 4-year-old girl, which was improved by intralesional corticosteroid injection and oral antimalarial drug with leaving postinflammatory hyperpigmentation.

Intralesional corticosteroid injection versus ablative fractional laser associated with corticosteroid drug delivery in the treatment of keloids: a comparative study

Intralesional corticosteroid injection versus ablative fractional laser associated with corticosteroid drug delivery in the treatment of keloids: a comparative study

Intralesional steroid and ultrasound therapy in patients with carpal tunnel syndrome

The study aimed to compare the effects of intralesional steroid injection and ultrasound therapy for the treatment of carpal tunnel syndrome. A total 130 patients divided into 2 groups: a) One group (n=65) received intralesional corticosteroid injection along with wrist splint, exercise, naproxen sodium 500 mg tablet and omeprazole 20 mg capsule twice daily for 2 weeks; b) Another group received (n=65) ultrasound therapy (10 min/day, 3 days/week for 4 weeks) along with Wrist splint for 4 weeks, exercises for 4 weeks, naproxen sodium 500 mg tablet and omeprazole 20 mg capsule twice daily for 2 weeks. The patients were followed-up 2 weekly for 4 weeks. The visual analogue score, symptom severity scores and functional status scores were significantly improved within each group at week 2 (p<0.05) and week 4 (p<0.05) except for the symptom severity score at (p>0.05). The improvement in symptom severity scores and functional status scores in the intralesional steroid group was more than in the ultrasound therapy group after 4 weeks.