Use of Botulinum Toxin Injections in the Treatment of Cold Intolerance.

There is currently no consensus on the treatment of cold intolerance in extremities in post-trauma patients. We aim to present two cases where botulinum toxin type A injections were used to improve symptoms of cold intolerance. Botulinum toxin type A (Allergan) was injected into the area around the palmar digital neurovascular bundle on both sides of the affected finger. We performed this in two patients, and both had good improvement of symptoms. One patient was discharged, and the other remained under routine follow-up with potential yearly botulinum injections to aid symptoms during the winter months. Both patients are pleased with their outcomes and report significant improvement from the low-risk treatment. In both described cases, injections of botulinum toxin had a significant effect on their symptoms. We conclude that botulinum toxin type A may be used as a treatment modality to improve symptoms of cold intolerance after trauma.

Case report: improving the speed and accuracy of melanoma sentinel node biopsy with 3D intra-operative imaging.

This case reports our first experience of using real-time intra-operative 3D imaging for sentinel lymph node biopsy in melanoma. The 3D imaging enabled ready identification and, excision of the sentinel node, by pinpointing its exact location.