RESUMO
The treatment of warts has always been a challenging prospect for dermatologists. In some cases, these warts can become resistant or recalcitrant to treatment. Although a plethora of therapeutic and destructive options is available for wart management, to date no treatment has been found to be completely effective because none of the agents induce specific antiviral immunity. We conducted a study to evaluate the efficacy and safety of skin needling with topical 100% trichloroacetic acid (TCA) against the same type of skin needling with bleomycin in patients with recalcitrant cutaneous warts. In total, 33 (63.5%) patients in the TCA group and 35 (81.4%) in the bleomycin group had complete clearance of all the warts, which was not statistically significant (P = 0.13). There was also no statistically significant difference between the treated and untreated warts in the bleomycin group, whereas in the TCA group there was a significantly higher response rate in the treated warts. The most common adverse event (AE) in both groups was transient procedure site pain. We found that the use of needling plus TCA leads to a faster resolution of warts compared with needling plus bleomycin, with a comparable safety profile. Additionally, we found that TCA is superior to bleomycin for management of multiple warts. However, needling with either TCA or bleomycin has excellent and fairly comparable efficacy, and these methods should be used for the management of multiple or recalcitrant warts, as they have minimal AEs and recurrence rates.
Assuntos
Ácido Tricloroacético , Verrugas , Administração Cutânea , Bleomicina/efeitos adversos , Bleomicina/uso terapêutico , Humanos , Injeções Intralesionais , Resultado do Tratamento , Ácido Tricloroacético/efeitos adversos , Verrugas/tratamento farmacológico , Verrugas/etiologiaAssuntos
Angiomatose , COVID-19 , Exantema , Angiomatose/diagnóstico , Humanos , Imunização , SARS-CoV-2RESUMO
BACKGROUND: Management of pyothorax and pneumothorax requires aspiration and/or intercostal drainage. CASE CHARACTERISTICS: We present two cases which were complicated by instrument-related events resulting in breakage of needle or intercostal drainage tube resulting in pleural foreign body. INTERVENTION/OUTCOME: The patients were stabilized and the foreign bodies retrieved using thoracoscopic approach. MESSAGE: Thoracoscopy provides a minimally invasive approach to deal with pleural foreign bodies.
Assuntos
Corpos Estranhos , Doença Iatrogênica , Toracoscopia , Tubos Torácicos/efeitos adversos , Pré-Escolar , Empiema Pleural/etiologia , Feminino , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico , Corpos Estranhos/cirurgia , Humanos , Recém-Nascido , Masculino , Agulhas/efeitos adversosRESUMO
Local and minor adverse reactions to diphtheria-pertussis-tetanus (DPT) vaccination are usually mild and appear within 48 hours of vaccination. We herein report a rare association with intramuscular DPT injection and discuss pertinent issues. Primary tuberculous abscess was the final diagnosis.
Assuntos
Abscesso/induzido quimicamente , Vacina contra Difteria, Tétano e Coqueluche/efeitos adversos , Abscesso/diagnóstico , Abscesso/cirurgia , Diagnóstico Diferencial , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Drenagem/métodos , Feminino , Humanos , Lactente , Injeções Intramusculares , Coxa da PernaRESUMO
Fibrous hamartoma of infancy is a rare benign tumour with local infiltration. The lesion is usually found in the upper torso and rarely occurs in the genital region. Diagnosis before surgery is rare, and complete excision is essential to prevent recurrence. We present a case in which fibrous hamartoma of infancy involving the spermatic cord was found. A pre-operative clinical diagnosis could not be made. On inguinal exploration, the tumour could not be dissected away from the testicular vessels, which necessitated an orchidectomy for complete removal. The case is presented due to its rarity and successful management.
Assuntos
Neoplasias dos Genitais Masculinos/patologia , Hamartoma/patologia , Neoplasias de Tecido Fibroso/patologia , Orquiectomia/métodos , Cordão Espermático/patologia , Biópsia por Agulha , Edema/diagnóstico , Edema/etiologia , Seguimentos , Neoplasias dos Genitais Masculinos/cirurgia , Hamartoma/cirurgia , Humanos , Imuno-Histoquímica , Lactente , Masculino , Neoplasias de Tecido Fibroso/cirurgia , Doenças Raras , Medição de Risco , Escroto/fisiopatologia , Cordão Espermático/cirurgia , Resultado do TratamentoAssuntos
Tumores Neuroectodérmicos Primitivos/patologia , Neoplasias Testiculares/patologia , Biomarcadores Tumorais/metabolismo , Biópsia por Agulha Fina , Pré-Escolar , Humanos , Imuno-Histoquímica , Masculino , Tumores Neuroectodérmicos Primitivos/metabolismo , Tumores Neuroectodérmicos Primitivos/cirurgia , Neoplasias Testiculares/metabolismo , Neoplasias Testiculares/cirurgiaRESUMO
Inguinal hernia is one of the most common conditions requiring surgical management in childhood. The usual presentation of congenital inguinal hernia in the pediatric age group is an inguino-scrotal swelling. We report a case of inguinal hernia in a child that presented as an abdominal wall swelling clinically suggestive of a Spigelian hernia.
Assuntos
Hérnia Inguinal/diagnóstico , Hérnia Ventral/diagnóstico , Criança , Diagnóstico Diferencial , Hérnia Inguinal/cirurgia , Humanos , MasculinoRESUMO
We present a preterm (32 weeks; weight 1300 g) neonate, with solitary hepatic abscess. The causative organism was Klebsiella. The child presented with septicemia, hepatomegaly and abdominal lump. Radiological investigations were inconclusive. Surgical drainage and prolonged antibiotic treatment led to resolution of the hepatic abscess.
Assuntos
Doenças do Prematuro/diagnóstico , Infecções por Klebsiella/diagnóstico , Abscesso Hepático/diagnóstico , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/terapia , Infecções por Klebsiella/terapia , Abscesso Hepático/terapia , Tomografia Computadorizada por Raios XRESUMO
Fetus-in-fetu (FIF) is a rare congenital condition first described in early nineteenth century. In this anomaly, a malformed parasitic twin is found within the body of its partner. Less than 100 cases have been described in the English-language literature.
Assuntos
Feto/anormalidades , Feminino , Humanos , Lactente , Masculino , Gravidez , Espaço Retroperitoneal/patologiaRESUMO
Herniotomy is performed for the surgical repair of hernia and along with orchiopexy for the closure of associated patent processus vaginalis. Ligation of the hernial sac has been considered mandatory for a successful repair. The present report was designed to study the results of non-ligation of the hernial sac before excision at the neck. It was found that non-ligation has no untoward effect on early complications and recurrence rate on long-term follow-up. It is suggested that it is not necessary to ligate the hernial sac during herniotomy in children.
Assuntos
Hérnia Inguinal/cirurgia , Criança , Pré-Escolar , Procedimentos Cirúrgicos do Sistema Digestório , Humanos , Lactente , Masculino , Estudos ProspectivosRESUMO
Forty-one infants with a pouch colon malformation accompanied by a high anorectal anomaly were treated between January 1986 and December 1990. The 41 cases constituted 9% of all anorectal malformations and 15.2% of high defects managed during this period. There were 32 boys and nine girls; three of the girls had an associated cloaca. Many of the babies presented in poor condition, with gross abdominal distension caused by the distended colonic pouch. The typical radiological feature was an enormously distended colonic shadow occupying more than 50% of the width of the abdomen. At the time of surgery, the patients were classified into 4 subgroups based on the length of the normal colon. All but three infants had a high wide fistula, with the genitourinary tract consisting of a colovesical fistula in males and a colovaginal or colocloacal fistula in females. Frequent associated malformations included duplication of the appendix and vesicoureteric reflux. The operations performed initially were a window colostomy of the pouch with or without division-ligation of the fistula, end-colostomy after fistula ligation, or subtotal pouch excision with tubularization of the remaining colon and end-colostomy. Thirteen of the 41 patients have undergone a definitive pull-through operation using the posterior sagittal approach, including two children in whom one-stage reconstruction of a cloaca was performed. Standardized management of this complex anomaly is proposed for the initial operation and for definitive reconstruction.
Assuntos
Anormalidades Múltiplas/cirurgia , Colo/anormalidades , Reto/anormalidades , Anormalidades Múltiplas/diagnóstico por imagem , Anormalidades Múltiplas/embriologia , Canal Anal/anormalidades , Protocolos Clínicos , Colostomia , Feminino , Humanos , Lactente , Recém-Nascido , Fístula Intestinal/complicações , Fístula Intestinal/diagnóstico por imagem , Fístula Intestinal/cirurgia , Ligadura , Masculino , Complicações Pós-Operatórias/mortalidade , Radiografia , Fístula Retal/complicações , Fístula Retal/diagnóstico por imagem , Fístula Retal/cirurgia , Procedimentos Cirúrgicos Operatórios/métodos , Fístula da Bexiga Urinária/complicações , Fístula da Bexiga Urinária/diagnóstico por imagem , Fístula da Bexiga Urinária/cirurgia , Fístula Vaginal/complicações , Fístula Vaginal/diagnóstico por imagem , Fístula Vaginal/cirurgiaRESUMO
Incomplete parasitic twinning with the parasite attached at the host's epigastrium is extremely rare. We report a case of epigastric parasitic twinning where the parasite with a well-developed pelvis and lower limbs had accessory pelvic organs and was attached to the host above an omphalocele. The parasite was excised and the omphalocele managed conservatively by mercurochrome application. A review of the four previously reported cases is presented along with a discussion of the possible etiopathogenesis and nomenclature of this condition.