Hip Injection under X-ray. Fluoroscopy tutorial. *Contains graphic detail*
Object not found!Keloid is a difficult-to-treat condition and an ideal treatment modality is not available. Carbon dioxide CO 2 laser is one of the modalities to treat keloids. To evaluate the effect of CO 2 laser ablation followed by intralesional steroids on keloids. This was a prospective, single-center, uncontrolled, open study. Twenty-eight patients having tbe keloids were included in the study. Keloids were ablated or excised with CO 2 laser dog steroids restless by intralesional steroid weeks apart for 6 months. Results were evaluated after 6 steroid injection under the skin surface of stopping of intralesional steroids.
Übersetzung für "skin dose" im Deutsch
Keloid is a difficult-to-treat condition and an ideal treatment modality is not available. Carbon dioxide CO 2 laser is one of the modalities to treat keloids. To evaluate the effect of CO 2 laser ablation followed by intralesional steroids on keloids. This was a prospective, single-center, uncontrolled, open study. Twenty-eight patients having 35 keloids were included in the study. Keloids were ablated or excised with CO 2 laser followed by intralesional steroid weeks apart for 6 months.
Results were evaluated after 6 months of stopping of intralesional steroids. Thirteen patients followed up regularly for intralesional steroids. During 6 months of follow-up after stoppage of steroids, only two patients showed recurrence.
Ten patients were irregular for intralesional steroids and seven of them showed recurrence. Difference in recurrence rate of regular and irregular patients was significant. Only CO 2 laser ablation is not sufficient for halting the pathogenesis of keloid formation. We therefore conclude that CO 2 laser followed by intralesional steroid is a useful therapeutic approach for the treatment of keloids; however, patients need to be observed for recurrence over the next 1 year.
Keloids are benign hyperplasias which may or may not be preceded by injury. They are refractory to treatment most of the times. Intralesional corticosteroids,[ 1 ] topical retinoic acid,[ 2 ] topical imiquimod cream,[ 3 ] surgery,[ 4 ] cryotherapy,[ 5 ] laser[ 6 ] and silicon sheeting[ 7 ] are mainly used for their treatment. We assessed the effect of carbon dioxide CO 2 laser ablation followed by intralesional steroid on 35 keloids of 28 patients.
A detailed clinical history and examination were done for each patient. Diagnosis of keloid was done on clinical basis. Size of each keloid was noted with the help of a scale. The patients with keloids of size less than 10 cm in any dimension, any duration and with or without any treatment taken in the past were included in the study. Written informed consent was taken. Photographs were taken on every follow-up e. Ltd, Shanghai, China has continuous, repetitive and super-pulse mode.
Energy per second power ranges from 0. Patients were treated on the basis of the size of lesions. Smaller lesions were vaporized using super pulse with 15 W power. Larger lesions were treated in single or stagewise manner by multiple puncture technique or by excision.
In multiple puncture technique, small full thickness punctures were created throughout the keloid tissue with a gap of mm between the two punctures by CO 2 laser. Super pulse for firm keloid or continuous for hard keloid mode was used with 15 W power [ Figure 1 ].
In excision, keloid tissue was excised from base with super pulse for firm keloid or continuous for hard keloid with a power output of 15 W [ Figure 2 ]. Keloid was ablated till upper reticular dermis, indicated by yellow to light brown faun color change. Topically mupirocin cream was given till the healing of the lesion. Patients were advised to maintain proper hygiene of the wound till complete healing.
Patients were evaluated weekly for 1 month to assess the wound healing. Detailed examination was done after 3 and 6 months of the surgery and size of keloid tissue with local and systemic side effects of corticosteroid were noted. After that, patients were followed up to look for recurrence. Small full thickness punctures were created throughout the keloid tissue with a gap of mm between the two punctures.
A total of 28 patients with 35 keloid lesions were treated with CO 2 laser followed by intralesional triamcinolone acetonide injection infiltrated at the margins of treated keloid.
Twenty-eight keloids were on chest, one was on ankle, three were on right flank, one was on abdomen, one was on left arm and one was on lateral side of right thigh. There was no or minimal pain after 7 days of procedure. Eight keloids showed no local side effects of intralesional steroid, three developed telangiectasias, five developed depigmentation and one developed atrophy.
Ten patients with 12 keloids did not come for follow-up regularly for intralesional steroid and hence did not complete the protocol. An average of three doses of intralesional steroids was taken by these irregular patients in comparison with eight doses of intralesional steroids of regular patients. Five patients were lost to follow-up.
We compared the results of regular follow-up patients with the irregular follow-up patients who had not taken intralesional steroid weekly as the study does not have a control group. Symptomatic relief was noted in most patients who took intralesional steroid regularly. Secondary complications were mild-to-moderate, manageable and acceptable to patients. Intralesional steroid injections during follow-up visits were found to be relatively painless probably because they are delivered in periphery or in soft-to-firm reappearing keloid tissue.
Keloids are benign hyperplasias of dermal collagen which may or may not be preceded by injury in susceptible persons. Carbon dioxide laser emits far infrared light of wavelength nm. Superpulse delivers a chain of rapid, short, microsecond pulses with high-peak power, which reduces collateral thermal damage.
In his study, he treated 13 patients with keloid, ablating them with CO 2 laser. He ablated keloid tissue with Argon laser creating multiple punctures throughout the depth of tissue. Two or more sittings may be required to ablate the whole keloid tissue with this multiple puncture technique. Again in , the same author published another study, in which he treated seven patients with nine keloids excising them with CO 2 laser. However, eight of the nine keloids recurred after a follow-up of 6 to 22 months.
In , Norris J. In this retrospective study, he focused on 31 patients with one or more keloids, 23 of whom were available for follow-up after CO 2 laser excision. One patient had no recurrence of her keloid after CO 2 laser excision, nine patients required steroids to suppress recurrences, and 13 patients were considered failures. In all, except one patient, the healing started by 4 weeks and complete healing of the treatment area occurred within 8 weeks.
One patient had depigmentation of the treated area. There were no side effects in other patients. We used the same approach and found that the patients who were regular for follow-up and took intralesional steroids at every weeks for 6 months had complete flattening of keloid tissue.
There was no reappearance of keloid tissue after a follow-up of 6 months of therapy in 11 patients with 15 keloids who were regular and completed the protocol.
There was no or minimum pain after 7 days of procedure. Wound healed with erythematous scar tissue within 3 weeks of procedure. Since we did not have a control group, we only compared the results of patients who followed up regularly and took intralesional steroid injections every weeks with those who did not. We found that the difference in recurrence rate of regular and irregular patients was statistically significant. This indicates that only CO 2 laser ablation is not sufficient for halting the pathogenesis of keloid formation.
It requires regular weekly intralesional steroid for a period of 6 months after ablation with CO 2 laser. Ablation with CO 2 laser followed by regular weekly intralesional steroid for 6 months, is a satisfactory approach for keloid management. Recurrence rate in the first 6 months is low.
Further studies with larger number of patients and longer follow-up are required to further assess efficacy of CO 2 laser with intralesional steroid in treatment of keloids. National Center for Biotechnology Information , U. J Cutan Aesthet Surg. This is an open-access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This article has been cited by other articles in PMC. Carbon dioxide laser, intralesional steroid, keloid. Open in a separate window. RESULTS A total of 28 patients with 35 keloid lesions were treated with CO 2 laser followed by intralesional triamcinolone acetonide injection infiltrated at the margins of treated keloid. Table 1 Follow-up log of patients at 6 months and 1 year after procedure.
Graph showing average dose of intralesional steroid ILS on follow-up visits. Follow-up at 1 year Regular patients Irregular patients Recurrence of Present 2 9 keloid tissue Absent 2 9. Footnotes Source of Support: Nil Conflict of Interest: Janssen de Limpens AM. The local treatment of hypertrophic scars and keloids with topical retinoic acid.
Berman B, Kaufman J. J Am Acad Dermatol. Cosman B, Wolff M. Correlation of keloid recurrence with completeness of local excision: Use of cryotherapy in the treatment of keloids. J Dermatol Surg Oncol. Preliminary results of argon and carbon dioxide laser treatment of keloid scars. Topical silicone gel sheeting in the treatment of hypertrophic scars and keloids. Physical and surgical principles governing carbon dioxide laser surgery on the skin.
Failure of carbon dioxide laser excision of keloids. Carbon dioxide laser in the treatment of cutaneous disorders.
skin dose - Deutsch Übersetzung - Englisch Beispiele | Reverso Context
 NARAYANAN, R., and N. C. GANGULI: Hormonal effect on certain glycolytic enzymes Inhibitory effect of steroid hormones on salivary amylase activity. Chromatography of urine after injection of progesterone in women affected with  NIKKARI, T.: Composition and secretion of the skin surface lipids of the rat: . Übersetzung im Kontext von „skin dose“ in Englisch-Deutsch von Reverso Context: It is given as an injection under the skin at a dose of 45 mg. The steroid is in a special chemical form (a diester) that makes it effective at low doses the skin surface after exposure and any present on the non-occlusive cover, including. In the skin of mice painted with methyl cholanthrene the number of collagen in the surrounding connective tissue had been suppressed by cortisone injections. and move with the cells slowly through the renewing epidermis to the surface.