RESUMEN
BACKGROUND: Local anesthetics are acidic and cause pain on infiltration into the skin. Two methods are commonly used by dermatologists to raise the pH of lidocaine with epinephrine: buffering with sodium bicarbonate or freshly mixing lidocaine with epinephrine on the day of use. OBJECTIVE: Our purpose was to compare the pain induced by infiltration of the skin with 1% lidocaine with epinephrine 1:100,000 buffered with sodium bicarbonate (buffered) versus 1% lidocaine freshly mixed with epinephrine (fresh). METHODS: Sixty volunteers were recruited for this prospective, double-blind study. Each subject received an intradermal injection of the buffered solution and the fresh solution. Immediately after each injection subjects rated the pain of infiltration on a 100-mm visual analog scale. The pain scores for the anesthetic solutions were compared using the paired t test. RESULTS: The pain score for the buffered solution was 18.3 +/- 20.3, and the pain score for the fresh solution was 23.5 +/- 19.1 (P = .0543). Sixty-five percent of subjects felt the fresh solution was more painful than the buffered solution. LIMITATIONS: The results did not reach statistical significance. CONCLUSION: In this small study, buffered lidocaine with epinephrine caused less pain on infiltration into the skin than lidocaine freshly mixed with epinephrine, but the results were not statistically significant.
Asunto(s)
Anestésicos Locales/efectos adversos , Epinefrina/efectos adversos , Lidocaína/efectos adversos , Dolor/inducido químicamente , Bicarbonato de Sodio , Anestésicos Locales/administración & dosificación , Tampones (Química) , Método Doble Ciego , Combinación de Medicamentos , Epinefrina/administración & dosificación , Humanos , Concentración de Iones de Hidrógeno , Inyecciones Intradérmicas , Lidocaína/administración & dosificación , Dolor/fisiopatología , Dimensión del Dolor , Soluciones/químicaRESUMEN
Imiquimod is a topically applied immunomodulator. Although initially approved for genital and perianal warts, dermatologists have prescribed this compound for many neoplastic and nonneoplastic skin conditions. The US Food and Drug Administration recently approved imiquimod for the treatment of actinic keratoses. This article reviews the literature on imiquimod in the treatment of cutaneous malignancies.
Asunto(s)
Aminoquinolinas/administración & dosificación , Antineoplásicos/administración & dosificación , Neoplasias Cutáneas/tratamiento farmacológico , Administración Cutánea , Ensayos Clínicos como Asunto , Humanos , ImiquimodRESUMEN
Leukemia cutis is an infrequent finding in patients with acute lymphocytic leukemia (ALL). We present a patient with Burkitt ALL (L3ALL) who developed leukemia cutis at the site of trauma.