Avoiding Surgery: Endoscopic Treatment of Congenital Duodenal Stenosis.

Duodenal stenosis is a rare congenital anomaly that is typically treated surgically, although endoscopic incisional therapy (EIT) and balloon dilation are minimally invasive alternatives. We present a case of a 15-month-old male with vomiting and difficulty tolerating solid food due to severe congenital duodenal stenosis. The patient underwent EIT and serial duodenal dilation to a diameter of 20 mm, which resulted in significant symptom improvement. Intralesional corticosteroid injection (ISI) was administered to help prevent the duodenal septum from restricturing. The combination of EIT, balloon dilation, and ISI was successful in treating the patient's congenital duodenal stenosis and avoided the need for surgery. However, further studies are required to confirm the efficacy of this treatment approach in this patient population. This report highlights the potential of this minimally invasive approach as an alternative to surgical intervention in the management of congenital duodenal stenosis.

Long-term remission of unusual plasmoacanthoma on the nasal canthus achieved by intralesional corticosteroid injection: Insights into the pathogenesis and treatment planning based on a literature review.

Plasmoacanthoma (PA) is a verrucous tumor predominantly developing on periorificial areas, which has been considered as an unusual subtype of plasmacytosis circumorificialis. Because of its rarity and clinical resemblance to several verrucous dermatological disorders, accurate diagnosis of PA is quite challenging. Herein, we present an extremely unusual case of PA which arose on both sides of the nasal canthus and was successfully treated with intralesional corticosteroid injections. To elucidate clinicopathological features of this condition, a literature review was also attempted. A 78-year-old woman visited us with a 2-year history of eruptions affecting both sides of the nasal canthus. At a local clinic, the diagnosis and treatment had been unsuccessful due to non-specific histological findings, leading to the referral to our institute. On physical examination, verrucous and lobulated reddish plaques were observed. In histology, psoriasiform epidermal change and dense plasma cell infiltration in the dermis were detected. The diagnosis of PA was made. After 5-monthly intralesional triamcinolone acetonide injections, the lesions became hardly noticeable with no evidence of recurrence. A literature review found five PA cases. PA predominantly arose on the periorificial area, mostly in or around the mouth, except one case which developed on the extra-oral or perioral area. Intralesional corticosteroid injection has been preferably performed, which frequently achieved successful remission. Chronic inflammation has been reported as a preceding condition. Abundance of plasma cells in the lacrimal glands and conjunctiva, together with pre-existing allergic conjunctivitis and habitual scratching, might have contributed to PA development in our case. Histopathological detection of psoriasiform epidermal change and dense dermal plasma cell infiltration is indispensable for the diagnosis of PA. For accurate diagnosis, optimization of treatment, and further accumulation of extra-oral/perioral PA cases, a skin biopsy needs to be proactively performed on verrucous lesions on relatively unfamiliar orifice sites.

Treatment of giant cell granuloma with intralesional corticosteroid injections: a case report.

Giant cell granuloma is rare in the head and neck region and most commonly affects the maxilla and mandible. Giant cell granulomas are benign but occasionally aggressive lesions that are traditionally treated with surgery. Because it is a benign process, less radical and non-surgical treatment alternatives are required. Corticosteroid injection is a viable alternative in the treatment of central giant cell granuloma to avoid surgery. We aim to present a case which was successfully treated with intralesional corticosteroid injection in the maxilla.

Intralesional corticosteroid injection as an effective treatment method for oral lesions: a meta-analysis

Intralesional corticosteroid injection (ICSI) is known as one of the main methods used for treating a wide range of lesions. It also results in a high concentration of drugs at lesion sites, with minimal systemic absorption. Thus, this study aimed to provide a review of the intralesional corticosteroid injection (ICSI) indications in the treatment of oral lesions. To this end; relevant key words were searched in the databases of PubMed, Google Scholar, Scopus, ScienceDirect, and UpToDate in the present study. Accordingly, the results of a total number of 62 case reports or case series articles were used in this study and the positive therapeutic effects of intralesional corticosteroid injection (ICSI) in 23 common oral lesions were reported. The most common type of intralesional steroid in the treatment of oral lesions was triamcinolone. No significant difference was also observed in terms of pain in patients following the use of steroid alone or in combination with anesthetic agents; moreover, the reported side effects of this method were exceptionally rare and transient. It was concluded that the intralesional corticosteroid injection (ICSI) could be one of the effective therapeutic methods with no significant problems in many oral lesions such as inflammatory, immunologic, and vascular ones due to its higher therapeutic effects than other topical forms of steroids and fewer side effects than systemic corticosteroid.

Pilot Study of the Efficacy of 578 nm Copper Bromide Laser Combined with Intralesional Corticosteroid Injection for Treatment of Keloids and Hypertrophic Scars.

BACKGROUND: Treatments including intralesional corticosteroid injection, pressure therapy, cryotherapy, and various laser therapies have had limited success for keloids and hypertrophic scars. OBJECTIVE: This trial evaluated the efficacy of a combination of 578 nm copper bromide laser and the more traditional intralesional corticosteroid injection for the treatment of keloids and hypertrophic scars with respect to scar color. METHODS: Keloids or hypertrophic scars of 12 Korean patients were treated five times by the combined treatment at 4-week intervals. Clinical improvement was assessed by the physicians' global assessment (PGA) comparing pre- and post-treatment photographs, as well as 4 weeks after the last treatment. Erythema intensity was quantified using a mexameter. RESULTS: Most scars showed significant clinical improvement in PGA and decreased erythema intensity after 5 treatments. All patients showed improvements in symptoms like pruritus. CONCLUSION: The combined treatment is effective for keloids and hypertrophic scars, especially when the telangiectatic portion of the scars is prominent. The adjunctive use of 578 nm copper bromide laser decreased the telangiectatic side effects of an intralesional corticosteroid injection by reducing the vascular components of scars.