ABSTRACT
The prevalence and medical costs of osteoporotic vertebral compression fractures (OVCFs) are on the rise. However, a concrete evidence-based treatment guideline has not yet been established. Despite that numerous randomized controlled trials (RCTs) were performed, the study design and outcome measurement were heterogeneous, and the results were not unified. The purpose of this review is to compare the results of high level-evidence studies to provide a background for evidence-based OVCF treatment. Many reports showed that vertebroplasty has better clinical outcomes than non-surgical treatment for OVCF, but the results of three double-blinded RCTs with the highest level of evidence did not show a significant difference between vertebroplasty and sham procedure. Whether undergoing surgical or non-surgical treatment, OVCF patient management should be started by managing osteoporosis first. Meanwhile, in the results of RCTs related to the comparison of conservative treatment modalities, the benefit of braces and a specific analgesic prescription protocol was also unclear. The presented results of each clinical trial were generally inconsistent and may not be appropriate in all situations. Any decision by clinicians to apply this evidence must be made considering individual patients and available resources. At present, controversy remains about the best treatment modality for OVCF. Large, multicenter, placebo/sham-controlled trials are needed to address this gap and establish strong evidence-based guidelines.
ABSTRACT
Melanoacanthoma is a variant of seborrheic keratosis which was first introduced by Mishima and Pinkus in 1960. This is a very rare and benign, epidermal tumor. Clinically, it is usually manifested in a pigmented, verrucous, round or oval plaque and nodular lesion. This is characterized histologically by nonpigmented keratinocytes and numerous large, richly dendritic melanocytes. We describe a 68-year-old man who suffered from a black-colored plaque on his right shin for 5 years. Melanoacanthoma was diagnosed by characteristic histopathologic findings.
Subject(s)
Aged , Humans , Keratinocytes , Keratosis, Seborrheic , MelanocytesABSTRACT
A neurilemmoma is a rare nerve sheath tumor in dermatology. The tumors are usually solitary and affect woman more frequently than men, but with no particular affinity for any age group. It occurs commonly along the main nerve trunks of the extremities, especially the flexor surface of the arms, wrists, and knees. We report a case of neurilemmoma on the left nasal vestibule of 47-years old woman. The tumor was a solitary, pinkish, polypoidal papule which gradually increased in size. A review of the literature revealed extremely rare documented cases of neurilemmoma occurring in the nasal vestibule.
Subject(s)
Female , Humans , Male , Middle Aged , Arm , Dermatology , Extremities , Knee , Neurilemmoma , WristABSTRACT
Pyoderma gangrenosum is an uncommon, chronic, recurrent cutaneous ulcerative disease. It is difficult to diagnosis and is frequently associated with systemic diseases. There is no specific therapy, nor effective uniform therapy. Systemic treatment with corticosteroids or cyclosporine, alone or together, appeared to be effective in many cases. However, prolonged therapy is associated with significant side effects, and in refractory cases, immunomodulatory therapy is needed. We report a case of pyoderma gangrenosum, which developed in a 41-years-old woman, who showed no symptoms of having an underlying systemic disease. The conduction was successfully treated with prednisolone, cyclosporine and dapsone.
Subject(s)
Female , Humans , Adrenal Cortex Hormones , Cyclosporine , Dapsone , Diagnosis , Immunomodulation , Prednisolone , Pyoderma Gangrenosum , Pyoderma , UlcerABSTRACT
Pyoderma gangrenosum is an uncommon, chronic, recurrent cutaneous ulcerative disease. It is difficult to diagnosis and is frequently associated with systemic diseases. There is no specific therapy, nor effective uniform therapy. Systemic treatment with corticosteroids or cyclosporine, alone or together, appeared to be effective in many cases. However, prolonged therapy is associated with significant side effects, and in refractory cases, immunomodulatory therapy is needed. We report a case of pyoderma gangrenosum, which developed in a 41-years-old woman, who showed no symptoms of having an underlying systemic disease. The conduction was successfully treated with prednisolone, cyclosporine and dapsone.
Subject(s)
Female , Humans , Adrenal Cortex Hormones , Cyclosporine , Dapsone , Diagnosis , Immunomodulation , Prednisolone , Pyoderma Gangrenosum , Pyoderma , UlcerABSTRACT
Photodynamic therapy (PDT) is a treatment modality using highly reactive oxygen intermediates generated by the interaction of light with a photosensitizer. It has been shown to be an effective treatment for the various cutaneous and noncutaneous malignancies. It is efficient for the curative and palliative treatment of epithelial skin tumors in situ, or early invasive lesions. We treated bowenoid actinic keratosis on the left hand with topical PDT using 5-aminolevulinic acid (ALA) and a low intensity (3.5 J/cm2) dye laser. After three sessions, the lesion had been completely cleared. We report a case of bowenoid actinic keratosis in 74-year-old man, who was treated with low intensity (3.5 J/cm2) dye laser following a topical application of 5-ALA.
Subject(s)
Aged , Humans , Actins , Hand , Keratosis, Actinic , Lasers, Dye , Oxygen , Palliative Care , Photochemotherapy , SkinABSTRACT
BACKGROUND: There are many growth media for cultivation of human melanocytes (MGM), depending on the supplements added, and the growth of cells is closely related to these components. To understand melanocytes in vivo, it is necessary to find out the biological or biochemical characteristics of melanocytes grown in physiologic growth medium (P-MGM) and phorbol-12-myristate 13-acetate (PMA)-containing medium (C-MGM). OBJECTIVE: To investigate the expression of different biochemical markers of melanocytes grown in C-MGM and in P-MGM. METHODS: C-MGM is basically composed of PMA (10 ng/ml), and bFGF (3 ng/ml), and is now commercially available for melanocyte culture. P-MGM is a physiologic growth medium containing physiologic mitogens such as bFGF (10 ng/ml), ET-1 (10 nM), and alpha-MSH (12 nM). The cell proliferation and the expression of biochemical markers were measured in cultured human melanocytes which were grown in either C-MGM or P-MGM. RESULTS: In this study, there was significant difference in cell proliferation between cells grown in C-MGM and P-MGM (p<0.01). The tyrosinase activity and melanin contents were significantly increased in C-MGM. The expression of TRP1, MART-1 and p53 in mRNA level was higher in C-MGM than in P-MGM. The up-regulation of p53 protein expression was also observed in C-MGM. CONCLUSION: The proliferation and expression of p53, at both transcriptional and translational levels were increased when melanocytes were grown in C-MGM, compared to P-MGM. This data suggests that p53-mediated melanization is to some degree related with phorbol ester, and should further be elucidated.