ABSTRACT
DESIGN: Interventional, prospective, four arm randomized control. SETTING: Outpatient department, Department of Dermatology, Venereology and Leprology, AIIMS Jodhpur (Rajasthan), India. PARTICIPANTS: Two hundred patients. METHODS: The intervention administered in the groups were normal saline (A), vitamin D3 (B), MIP (C), and MMR (D). The injections were given into the largest wart at 2-weekly intervals until complete clearance or for a maximum of seven sittings. Post-treatment clearance of the injected wart and the distant wart was compared on the basis of change in wart number, percentage clearance, and mean time to complete clearance. Side effects were recorded. RESULTS: A total of 197 patients were recruited. The mean percentage improvement in the injected and non-injected warts was 68.4% and 66.8%, respectively. Intention to treat analysis (ITT) showed that complete clearance of lesions in injected wart occurred in placebo, vit D3 , MMR, and MIP arms in 64%, 66%, 58%, and 55% patients, respectively (p > 0.05), while in the non-injected warts in 62%, 64%, 52%, and 53%, respectively (p > 0.05). The mean time to achieve complete clearance of wart was fastest in MIP at 7.1 weeks followed by MMR at 7.2 weeks, VIT D3 at 7.4 weeks and in placebo group 7.8 weeks (p > 0.05). Side effects noted were fever, pain, erythema, and swelling which was highest in VIT D3 group (p < 0.05). CONCLUSION: The efficacy of immunotherapies was comparable to placebo with minimal side effects.
Subject(s)
Papilloma , Warts , Humans , Cholecalciferol/adverse effects , Measles-Mumps-Rubella Vaccine/adverse effects , Prospective Studies , Injections, Intralesional , India , Warts/drug therapy , Vitamin D , Papilloma/drug therapy , Vitamins/adverse effectsSubject(s)
Lymphoma, T-Cell, Cutaneous , Lymphoma, T-Cell , Panniculitis , Skin Neoplasms , Humans , Lymphoma, T-Cell, Cutaneous/pathology , Methotrexate/therapeutic use , Neoplasm Recurrence, Local , Panniculitis/diagnosis , Panniculitis/drug therapy , Panniculitis/pathology , Skin Neoplasms/drug therapy , Skin Neoplasms/pathologySubject(s)
Hodgkin Disease/complications , Lymphomatoid Papulosis/diagnosis , Skin Neoplasms/diagnosis , Aged , Glucocorticoids/therapeutic use , Histamine Antagonists/therapeutic use , Humans , Lymphomatoid Papulosis/complications , Lymphomatoid Papulosis/drug therapy , Lymphomatoid Papulosis/pathology , Male , Neoplasm Recurrence, Local , Skin Neoplasms/complications , Skin Neoplasms/drug therapy , Skin Neoplasms/pathologyABSTRACT
BACKGROUND: Platelet-rich plasma (PRP) has been found to be effective in treating periorbital hyperpigmentation (POH). PRP prepared by double-spin (DS) method and activated by calcium has been used conventionally. PRP can be prepared by single spin (SS) and activated at low temperature (novel method), but the evidence is limited. OBJECTIVE: To compare the novel and conventional PRP in the treatment of periorbital hyperpigmentation. METHODS: We selected 21 patients of POH and randomly divided the face into two halves. One-half of the face (group A) was treated with novel PRP (SS and low-temperature activation). The other half (group B) was treated with conventional PRP (DS and calcium activation). A total of 3 PRP injections were given at 4 weekly intervals. Patients were observed and assessed on 12th week by photography, dermoscopy, visual analog scale (VAS) score, and Dermatology life quality index (DLQI). Platelet counts and growth factors were assessed in PRP. RESULTS: Mean platelet count in novel and conventional PRP was 7.41 ± 1.76 lacs and 8.17 ± 2.23 lacs (p = 0.348). Mean photographic and dermoscopic assessment at the end of the study in group A and group B was 52.33 ± 6.468 and 53.14 ± 6.99 (p = 0.151). Change in VAS in groups A and B was 3.85 ± 1.27 and 3.90 ± 1.04 (p = 0.895). Levels of various growth factors assessed by ELISA did not differ significantly. There was significant decline in DLQI. CONCLUSION: The novel method is not inferior to conventional method of PRP in the treatment of periorbital hyperpigmentation.
