A new method to reduce pin-prick pain of intra-muscular and subcutaneous injections.

AIM: Although about 10% of the normal population is thought to be needle-phobic, no method to reduce pin-prick pain is currently available for large scale application. We describe a new simple and easy-to-do method to reduce pin-prick pain through the pressure of multiple blunt pins at the injection site. METHODS: Two-hundred and twelve patients were randomly assigned to 2 groups. The treated group (n= 106) received intramuscular and subcutaneous injections with the application of the blunt pins and the control group (n= 106) with a placebo device. Pain was tested with the visual analogue scale on a 0 (no pain)-10 (maximum pain) scale. RESULTS: After intramuscular injections a significant (P< 0.0001) pain reduction in the treated group compared to placebo was observed: 1.90+/-1.27 versus 5.16+/-1.37 (mean pain reduction: 63.2%); 88.5% of the patients in the treated group and 11.4% in placebo group rated the pain as = or < 3. After subcutaneous injections mean reported pain in the treated group compared to placebo was: 0.32+/-0.51 versus 2.61+/-0.77 (mean pain reduction: 87.7%) (P< 0.0001); 95.1% of the patients in the treated group and 9.8% in the placebo rated the pain as = or <1. No side effects were observed. CONCLUSIONS: Multiple blunt pins pressure on the skin, at the time of intramuscular or subcutaneous injection is able to significantly reduce pin-prick pain. The underlying physiological mechanisms are briefly discussed.

Sneddon's syndrome: clinical and immunohistochemical findings.

Results of immunological studies on skin biopsies of 5 patients with Sneddon's syndrome are reported. Also studied were coagulation factors and autoantibodies believed to play a role in this syndrome. Hemostasis was normal except for a mild increase of fibrinogen in one subject; lupus anticoagulant (LAC) and anticardiolipin antibodies were negative in all. The skin biopsies ruled out systemic vasculitis and vasculitis in association with connective tissue diseases. Sneddon's syndrome is a peculiar clinicopathological condition, probably with several etiologies, but is distinct from primary antiphospholipid syndrome.

Tinea corporis bullosa.

The paper reports a case of tinea corporis bullosa in a 63-year-old woman. Near the classical annular lesions on the anterior surface of the left leg, the patient presented frank bullous lesions. Serous fluid from the bulla yielded Microsporum canis, the first report of the association of this fungus with bullous lesions in tinea corporis. The patient was investigated with routine examinations and immunological studies which showed an intense inflammatory process much greater than in usual cases of tinea corporis.

[The use of CO2 laser in ambulatory dermatologic surgery]. / Utilizzo del laser CO2 in campo chirurgico dermatologico ambulatoriale.

The Authors assess the use of CO2 laser in out-patient dermatological surgery starting with the theoretical grounds for the use of laser surgery and including its practical application in out-patient clinics. Following a review of the literature, the paper describes the Authors' personal experience in the Laser Dermatological Surgery Outpatient Clinic of the Centro Resnati-Respighi at the San Raffaele Hospital in Milan. The efficacy and suitability of CO2 laser surgery are evaluated.