RESUMEN
BACKGROUND: Verrucae plantaris is a viral disease caused by human papilloma virus that is commonly seen in the office setting and is often challenging to treat owing to its high recurrence rate and recalcitrant profile. Candida albicans intralesional injections have been hypothesized to incite an immunogenic response toward the virus. METHODS: We report on the immunotherapeutic effect of intralesional injection of C albicans into plantar verrucae with a retrospective medical record analysis of 80 patients. Using a luer-lock syringe, 0.1 to 0.3 mL of C albicans antigen was injected into either the first known lesion or the largest lesion. RESULTS: The success rate of intralesional C albicans, defined as total clearance of the lesion, was 65%, which may be underestimated because patients lost to follow-up were included in the 35% failure rate. It was also found that female patients with a previous tissue-destructive treatment process were more than four times more likely to respond to C albicans therapy, whereas this effect was less pronounced in the male patient population. CONCLUSIONS: These results indicate that a series of intralesional injections of C albicans is an effective and efficient method of treatment for verrucae plantaris.
Asunto(s)
Antígenos Fúngicos/administración & dosificación , Candida albicans/inmunología , Enfermedades del Pie/terapia , Inmunoterapia/métodos , Verrugas/tratamiento farmacológico , Adulto , Femenino , Humanos , Inyecciones Intralesiones , Masculino , Estudios Retrospectivos , Resultado del Tratamiento , Verrugas/diagnósticoRESUMEN
Charcot foot syndrome (Charcot neuroarthropathy affecting the foot), particularly in its latter stages, may pose a significant technical challenge to the surgeon. Because of the lack of anatomic consistency, preoperative planning with virtual and physical models of the foot could improve the chances of achieving a predictable intraoperative result. In this report, we describe the use of a novel, inexpensive, 3-dimensional template printing technique that can provide, with just a normal printer, multiple "copies" of the foot to be repaired. Although we depict this method as it pertains to repair of the Charcot foot, it could also be used to plan and practice, or revise, 3-dimensional surgical manipulations of other complex foot deformities.
Asunto(s)
Artropatía Neurógena/cirugía , Simulación por Computador , Deformidades Adquiridas del Pie/cirugía , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional , Procedimientos de Cirugía Plástica/métodos , Cirugía Asistida por Computador/métodos , Artropatía Neurógena/complicaciones , Artropatía Neurógena/diagnóstico por imagen , Deformidades Adquiridas del Pie/diagnóstico por imagen , Deformidades Adquiridas del Pie/etiología , Humanos , RadiografíaAsunto(s)
Herpes Zóster/diagnóstico , Pierna/virología , Acetaminofén/uso terapéutico , Aciclovir/análogos & derivados , Aciclovir/uso terapéutico , Analgésicos no Narcóticos/uso terapéutico , Analgésicos Opioides/uso terapéutico , Antivirales/uso terapéutico , Diagnóstico Diferencial , Femenino , Herpes Zóster/tratamiento farmacológico , Humanos , Lidocaína/uso terapéutico , Masculino , Persona de Mediana Edad , Tramadol/uso terapéutico , Valaciclovir , Valina/análogos & derivados , Valina/uso terapéuticoRESUMEN
Hyperhidrosis is defined as excessive and uncontrollable sweating due to overactivity of the eccrine sweat glands. The first line of treatment for plantar hyperhidrosis consists of conservative therapies such as topical solutions (ie, antiperspirant applications and aluminum chloride preparations) and iontophoresis. When the patient has failed these standard treatments, the other available medical options are rather limited and not well tolerated. Botulinum toxin type A (Botox, Allergan Inc, Irvine, California) is a purified neurotoxin complex approved by the US Food and Drug Administration in 2004 for multiple medical conditions, including severe primary axillary hyperhidrosis that failed conservative topical therapies. Few recent clinical studies have suggested that botulinum toxin is effective in the treatment of plantar hyperhidrosis. In this case study, two patients received intradermal injections of botulinum toxin type A into the plantar aspect of both feet. A 3-month follow-up evaluated the efficacy of botulinum toxin type A by subjectively assessing the amount of residual sweating. In these two patients, botulinum toxin type A was an effective and safe treatment for plantar hyperhidrosis.