International journal of dermatology
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Comparative Study
Hypertrophic and keloidal scars: an approach to polytherapy.
Cryotherapy and intralesional corticosteroids have been used separately or in combination as a treatment for hypertrophic and keloidal scars. The addition of silicone gel to the treatment schedule might be of interest. ⋯ Our study suggests that polytherapy may be an effective tool in the therapy of hypertrophic and keloidal scars.
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Abstract The larval stages of the fly Cochliomyia hominivorax are responsible for myiasis, which primarily affects wounds. We report the case of a bed-ridden patient with dementia who developed right nasal myiasis during his stay at Cayenne Hospital. Progression was favorable, but the nasal pyramid was partially destroyed. In zones where this fly is endemic, particular attention should be given to hospitalized patients with wounds and consciousness problems.
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Case Reports
Scrotal ulceration induced by all-trans retinoic acid in a patient with acute promyelocytic leukemia.
All-trans retinoic acid (ATRA) has been shown to improve the outcome in patients with acute promyelocytic leukemia compared with chemotherapy alone, but it is associated with adverse effects. We report the development of scrotal ulcer in a patient with acute promyleocytic leukemia (APL) within 10 days of treatment with ATRA at a dose of 40 mg orally twice daily. The ulcer did not respond to antibiotic treatment and healed shortly after withholding ATRA. The biopsy showed inflammation only, and other microbiological workup was negative.
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Randomized Controlled Trial Comparative Study Clinical Trial
Endogenous opioids, mu-opiate receptors and chloroquine-induced pruritus: a double-blind comparison of naltrexone and promethazine in patients with malaria fever who have an established history of generalized chloroquine-induced itching.
Chloroquine induces a severe generalized pruritus, in predisposed Black African patients, during treatment of malaria fever, and also in some Caucasian patients treated for rheumatological diseases. We have previously shown that chloroquine may release endogenous opioids and/or interact with micro-opiate receptors in rats, and that both histamine and malaria parasite blood density, contribute to the itching severity in malaria fever in humans. The aim of our present study was to assess and compare the antipruritic efficacy of the micro-opiate receptor antagonist, naltrexone, and the antihistamine, promethazine, in chloroquine treated patients with malaria fever. ⋯ Naltrexone exerted an antipruritic action, at least to a similar extent to promethazine in patients with chloroquine-induced itching in malaria fever. However, the relationship between parasite density and resultant pruritus was significantly different between naltrexone and promethazine. Thus, micro-opiate receptors/and or endogenous opioids may contribute to chloroquine itching in malaria fever, in humans, in accord with animal experimental findings. Malaria parasite density in blood is a strong determinant of itching severity in patients predisposed to chloroquine-induced pruritus.