ABSTRACT
Objective:To assess the efficacy, safety of adding intralesional compound betamethasone injection to EEBD to reduce restricture.Methods:77 patients, treated in The first people's hospital of YancHeng from January, 2015 to December, 2018, were randomized to receive EEPD combined with either compound betamethasone injection or placebo injection. A total of 2 ml of compound betamethasone injection or an identical volume of normal saline solution as a placebo was injected per site using a 23-gauge needle immediately after EEPD. Patients and treating physicians were blinded to the treatment. The primary endpoint was the number of dilations required to resolve the stricture、restricture-free survival、time required to resolve the stricture and adverse events.Results:During the 4-years study period, Finally , 74 patients , who were randomized to either the steroid group (37 cases) or placebo group (37 cases), comprised the per-protocol population .The median number of EEPD required to resolve strictures was 2.0( IQR 1.0-3.0) in the steroid group and 3.0 ( IQR 3.0-4.5) in the placebo group ( P<0.001). After 6 months of follow-up, 27.0% of patients who had received steroid injections remained recurrence free compared with 3.5% of those who had received saline injections( P<0.001). The median time of EEPD required to resolve the stricture was 88 days( IQR 0-98 days)in the steroid group and 131 days( IQR 97-157 days)in the placebo group( P<0.001). No adverse events occurred related to the EEPD or steroid injection occurred. Conclusion:Endoscopic esophageal probe dilation combined with compound betamethasone injection shows promising results for the prevention of stricture recurrence in patients of anastomotic strictures.
ABSTRACT
Primary cutaneous plasmacytoma (PCP) is a very rare cutaneous B-cell lymphoma that arises primarily in the skin. A few cases of PCP have been reported previously. PCPs are histologically similar to cutaneous B-cell lymphoma and are characterized by dense monoclonal plasma cell infiltration in the dermis. PCP can manifest as a single lesion or as multiple lesions. A solitary lesion can be treated with surgical excision or local radiotherapy. We describe the case of a patient with primary cutaneous plasmacytoma that was treated with intralesional steroid injections.
Subject(s)
Humans , Dermis , Lymphoma, B-Cell , Plasma Cells , Plasmacytoma , Radiotherapy , SkinABSTRACT
No abstract available.
ABSTRACT
PURPOSE: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. MATERIALS AND METHODS: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. RESULTS: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. CONCLUSION: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.
Subject(s)
Child , Humans , Age of Onset , Biopsy , Bone Transplantation , Curettage , Diagnosis , Eosinophilic Granuloma , Follow-Up Studies , Fractures, Spontaneous , Histiocytosis, Langerhans-Cell , Medical Records , Osteolysis , Radiography , Retrospective Studies , Shoulder , Torticollis , Treatment OutcomeABSTRACT
Granuloma faciale is an uncommon disease of an unknown origin, and it is characterized by single or multiple erythematous facial skin lesions. Histologically, a narrow Grenz zone of normal dermis is observed between the epidermis and the dense dermal polymorphous infiltrates. The course of granuloma faciale is chronic and the response to therapy is usually poor. We report here a case of granuloma faciale in a 37-year-old male who presented with a 13-year history of a solitary, red-brown, soft, elevated, irregular shaped plaque on the chin. The biopsy specimen showed a Grenz zone and a dense, dermal infiltrate of mononuclear cells mixed with numerous eosinophils and neutrophils that displayed a diffuse and perivascular pattern. After 4 courses of intralesional steroid injection, the lesion almost became flattened, although it remained a pinkish patch. The lesion almost cleared up after 4 months of applying 0.03% topical tacrolimus.
Subject(s)
Adult , Humans , Male , Biopsy , Chin , Dermis , Eosinophils , Epidermis , Granuloma , Injections, Intralesional , Neutrophils , Skin , TacrolimusABSTRACT
We report a case of bilateral chondrodermatitis nodularis chronica helicis, on both helices, in a 60-year-old male patient. He presented with a 1-year history of two tender, firm, dark-brownish, 0.4x0.4cm-sized nodules with central ulceration on both helices. He had no history of trauma. A punch biopsy specimen taken from the nodule revealed central ulceration, hyperkeratosis, and irregular acanthosis of the epidermis. Within the dermis, there was inflammatory cell infiltration, dilatation and proliferation of vessels, and some eosinophilic collagen degeneration associated with degenerative cartilage. Based on these clinical and histologic findings, we diagnosed this as a rare case of bilateral chondrodermatitis nodularis chronica helicis occurring on both helices. We treated the lesions with intralesional steroid injections.