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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Erythromelalgia is characterized by paroxysmal burning pain and redness of the distal extremities; primary and secondary forms exist. Secondary erythromelalgia is most commonly associated with essential thrombocythemia and polycythemia vera, and the pathogenic mechanism is thought to be platelet aggregation. Thrombotic thrombocytopenic purpura is characterized by thrombocytopenia, microangiopathic anemia, renal failure, and fluctuating neurologic signs and symptoms. The pathogenic mechanism suggested for thrombotic thrombocytopenic purpura is diffuse platelet aggregation. We describe a female patient in whom thrombotic thrombocytopenic purpura was associated with erythromelalgia. This has not been previously reported.
J Am Acad Dermatol 1992 May
PMID:Erythromelalgia in a patient with thrombotic thrombocytopenic purpura. 161 44

Topical and systemic steroids have proven to be invaluable agents in the treatment of a wide range of disorders, but their use is not without potential complications. Before initiation of therapy with systemic steroids, a personal or family history of cataracts, glaucoma, hypertension, diabetes, hyperlipidemia, renal stones, peptic ulceration, and current infection or pregnancy should be ascertained, because these patients have an increased risk of complications. Prior to long-term therapy with systemic steroids, blood pressure measurement, tuberculin skin test, and anergy panel are recommended. Monthly follow-up may include measurements of weight, blood pressure, electrolytes, and blood sugar and guaiac testing of the stool. To prevent the ocular complications of steroid therapy, routine screening is indicated (Table 1). Screening for cataracts, which occur most commonly as a sequela of continuous systemic steroid use, may be performed by slit-lamp examinations conducted three or four times a year for patients on long-term therapy and twice a year for patients taking intermittent topical ocular or systemic steroids. Glaucoma is more often associated with topical ocular or periocular steroids than with systemic steroids; recommended screening includes a baseline intraocular pressure measurement, then routine pressure measurements taken every few weeks initially, then every few months. Ocular rebound inflammation may develop secondary to rapid tapering or abrupt discontinuation of topical ocular steroid use and is best prevented with gradual tapering. Opportunistic infections of the eye include bacterial, viral, and fungal infections and are most often associated with the use of topical ocular steroids. Ophthalmologic evaluation is indicated promptly if patients treated with ocular steroids develop ocular discharge, pain, photophobia, or redness.
Dermatol Clin 1992 Jul
PMID:Ocular effects of topical and systemic steroids. 161 9

The treatment of varicose veins as taught within the specialty of phlebology consists of the best combinations of sclerotherapy and surgery after a thorough evaluation by physical examination and Doppler ultrasound, as well as other techniques. Although patients can experience some relief of symptoms by external compression hosiery, only treatment that closes up leaky valves will stop the progression of disease. Sclerotherapy is a safe, well-accepted, non-investigational, highly effective method to treat abnormally enlarged veins. Surgical procedures may be necessary to supplement sclerotherapy in certain anatomic sites. Varicose veins cause patients to experience pain, lose time from work, and can ultimately lead to permanent disability. Our healthcare system must provide the most high quality cost effective care for these patients. By keeping costs down as compared with full-scale surgical procedures, the approach of sclerotherapy or sclerotherapy with outpatient surgery, performed by properly trained physicians, provides a means to accomplish this. Medical necessity criteria allow exclusion of payments for patients seeking treatment purely for cosmetic needs.
J Dermatol Surg Oncol 1992 Jul
PMID:The Bulletin of the North American Society of Phlebology. Insurance Advisory Committee Report. 162 35

Removal of the nail matrix is indicated in a variety of recalcitrant conditions in which the growth of the nail plate causes mechanical problems such as recurrent onychocryptosis or pain due to pinching or pressure. Before performing a matricectomy, the physician must consider the use of nonsurgical methods and the possible contraindications to surgery. Once the decision for matricectomy is made, the physician should then utilize the modality with the least morbidity and greatest convenience for the patient. A wide repertoire of methods of matricectomy is available for use; all methods, when performed properly, have similar high rates of cure.
J Dermatol Surg Oncol 1992 Aug
PMID:Matricectomy. 164 46

Ingrowing toenails are a very common condition that has a significant associated morbidity. Although treated by practitioners of many specialties, most doctors have minimal training in this area. In this overview, an algorithm will be used to direct in an efficient and pain minimizing way the management of recalcitrant ingrowing nails.
J Dermatol Surg Oncol 1992 Aug
PMID:Recalcitrant ingrowing nails. Surgical approaches. 164 48

Intralesional bleomycin has been effective treatment of recalcitrant verrucae since 1970, but one major drawback is the moderate to severe pain associated with the injection. To minimize procedural discomfort, bleomycin can be reconstituted in lidocaine. It is effective, associated with minimal morbidity, and well tolerated by most patients.
J Am Acad Dermatol 1991 Sep
PMID:Bleomycin-lidocaine mixture reduces pain of intralesional injection in the treatment of recalcitrant verrucae. 171 25

Pruritus is a significant problem for many patients undergoing long-term hemodialysis. Topical capsaicin depletes and prevents the reaccumulation of substance P in peripheral sensory neurons. Substance P functions in the transmission of pain and probably itch sensations. An open-label, uncontrolled trial and a double-blind, vehicle-controlled trial were conducted to evaluate the efficacy and safety of capsaicin 0.025% cream in the treatment of localized areas of pruritus in patients undergoing long-term hemodialysis. Eight of nine evaluable patients in the open-label trial reported marked relief or complete resolution of itching during the study period, and two of five evaluable patients in the double-blind trial reported complete resolution of itching in the capsaicin-treated arm with no or minimal improvement in the vehicle-treated arm. Twelve patients in the open-label trial and two in the double-blind trial were unevaluable. No serious treatment-related adverse reactions occurred.
J Am Acad Dermatol 1992 Jan
PMID:Topical capsaicin for treatment of hemodialysis-related pruritus. 173 43

Prior to skin surgery, localized cryoanesthesia is initially obtained utilizing Cryogel packs before local anesthesia injection, minimizing or abolishing pain from the piercing of the skin by the injection needle. The surgical field is then infiltrated with benzyl alcohol-containing normal saline, a painless solution producing moderate local anesthesia. Subsequently, a stronger anesthetic containing a vasoconstrictor or other desired additives can be infiltrated without significant patient discomfort. This simple three-step method has resulted in excellent patient acceptance, and is potentially useful for a wide range of surgical procedures and medical specialties.
J Dermatol Surg Oncol 1992 Jan
PMID:The ice-saline-Xylocaine technique. A simple method for minimizing pain in obtaining local anesthesia. 174 May 64

Chondrodermatitis nodularis chronica helicis is a painful, persistent, or recurrent inflammatory lesion involving the cartilage and skin of the external ear. These lesions are resistant to many therapeutic modalities and often recur even after surgical excision. The CO2 laser was used to vaporize the cutaneous nodules and involved cartilage. The wounds were allowed to heal with only minimal care using hydrogen peroxide cleansing and applications of topical antibiotic ointment. Twelve lesions have been treated with no recurrences after 2 to 15 months. There have been no complications or infections following laser surgery. The pain from these lesions is gone immediately following laser surgery. Healing with excellent cosmetic results is complete usually within 3 to 4 weeks.
J Dermatol Surg Oncol 1991 Nov
PMID:Chondrodermatitis nodularis chronica helicis. Successful treatment with the carbon dioxide laser. 128 23

Twenty-one patients were included in a double-blind, placebo-controlled, cross-over study with a eutectic mixture of lidocaine and prilocaine (EMLA). EMLA or placebo was placed on the upper lip for 1 hour; diathermy was then performed for 10 minutes. The pain caused by diathermy was evaluated by the patients and the cosmetologist on a four-point scale. The results of the investigation showed that there was significantly less pain after application of 5 gm of EMLA cream on the upper lip than after application of placebo, assessed both by the patient and by the cosmetologist. Eighteen of 20 patients preferred EMLA (p less than 0.0001). Local reactions were few and mild.
J Am Acad Dermatol 1991 Nov
PMID:Epilation of upper lip hirsutism with a eutectic mixture of lidocaine and prilocaine used as a topical anesthetic. 180 4


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