ABSTRACT
Hidradenitis suppurativa is a debilitating inflammatory skin disease with a chronic course and often disappointing response to treatment. Though a minority of persons (20%) reports symptom remission during pregnancy, the vast majority experiences no relief (72%), and few experience clinical deterioration (8%). Disease flares are also observed post-partum. The pathophysiological basis for pregnancy-associated fluctuations in clinical status is currently unknown. Because most women with HS require ongoing management throughout pregnancy, it is important to evaluate the suitability and safety of current treatment options for pregnant women. The following review will outline current management strategies for HS and their compatibility with pregnancy and lactation.
Subject(s)
Hidradenitis Suppurativa/therapy , Pregnancy Complications/therapy , Anti-Bacterial Agents/adverse effects , Biological Products/adverse effects , Contraindications , Cryotherapy , Female , Hidradenitis Suppurativa/drug therapy , Hidradenitis Suppurativa/surgery , Homeopathy , Humans , Immunosuppressive Agents/adverse effects , Lactation , Laser Therapy , Metformin/therapeutic use , Pain Management , Pregnancy , Pregnancy Complications/drug therapy , Pregnancy Complications/surgery , Smoking CessationABSTRACT
Warts and molluscums contagiosums are two benign viral skin diseases that commonly affect children. Contamination occurs by autoinoculation or during skin to skin contact. Molluscums contagiosums are more frequent in immunodeficient and atopic children. Swimming-pool practice and contact sports favour warts transmission. The choice of treatment depends upon the age of the child and the number and location of the lesions. Natural resolution can be awaited when lesions are limited. In first intent, curettage of the lesions under local anesthesia for molluscums contagiosums, salicylic acid preparation or cryotherapy according to location for warts, are the treatment of choice. In neither affection school ousting is necessary.
Subject(s)
Molluscum Contagiosum , Warts , Adjuvants, Immunologic/therapeutic use , Age Factors , Child , Child, Preschool , Cryotherapy , Curettage , Electrocoagulation , Female , Homeopathy , Humans , Hypersensitivity/complications , Immunocompromised Host , Immunologic Deficiency Syndromes/complications , Keratolytic Agents/therapeutic use , Male , Molluscum Contagiosum/epidemiology , Molluscum Contagiosum/therapy , Warts/epidemiology , Warts/therapyABSTRACT
INTRODUCTION: Warts are caused by the human papillomavirus (HPV), of which there are over 100 types, which probably infects the skin via areas of minimal trauma. Risk factors include use of communal showers, occupational handling of meat, and immunosuppression. In immunocompetent people, warts are harmless and resolve as a result of natural immunity within months or years. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for warts (non-genital)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 12 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic, review we present information relating to the effectiveness and safety of the following interventions: intralesional bleomycin; cimetidine; contact immunotherapy; cryotherapy; duct tape occlusion; formaldehyde, glutaraldehyde; homeopathy; photodynamic treatment; pulsed dye laser; surgical procedures; topical salicylic acid; and zinc sulphate.
Subject(s)
Cryotherapy , Warts , Administration, Oral , Bandages , Bleomycin/therapeutic use , Cimetidine/therapeutic use , Cryosurgery , Humans , Warts/drug therapy , Zinc Sulfate/therapeutic useABSTRACT
A randomised double blind trial was carried out over the first two days after thoracotomy to compare the analgesic effects of rectal indomethacin 100 mg administered eight hourly, cryoanalgesia, and a combination of both of these with the effects of conventional intramuscular opiate analgesia. Pain scores were significantly reduced with both rectal indomethacin alone and cryoanalgesia alone; these treatments had an additive effect when used in combination. Pain on movement was significantly increased, and indomethacin was more effective in reducing this than cryoanalgesia. Groups receiving either indomethacin alone or the combination treatment required significantly less opiate on the first day and exhibited improved peak flow values over the first two days. It is concluded that rectal indomethacin, in this dosage, can provide good, safe analgesia after thoracotomy with minimum administrative difficulty. When used as an adjunct to cryoanalgesia it has an additive effect. There are many potential uses for this drug in other branches of surgery.