clobetasol and Postoperative-Complications

The effects of topical indomethacin and clobetasol propionate on erythema and oedema following low-dose cryotherapy to normal skin were examined using a single-blind technique. Both agents significantly reduced erythema, but neither had a significant effect on oedema. A further, controlled, double-blind study comparing topical indomethacin and inert gel base was performed after cryotherapy to hand warts. In this study, topical indomethacin had no significant effect on post-cryotherapy oedema, erythema, pain or blister formation 48 and 96 h after treatment. Both potent topical steroids and cyclo-oxygenase inhibitors reduce erythema after low-dose cryotherapy. In clinical practice, there is no evidence that topical indomethacin significantly inhibits the inflammatory response to cryotherapy.

Topics: Administration, Topical; Adolescent; Adult; Child; Clobetasol; Cryotherapy; Dermatitis; Double-Blind Method; Edema; Erythema; Female; Humans; Indomethacin; Male; Middle Aged; Postoperative Complications; Skinfold Thickness; Warts

The effect of fluoromethalone 0.1% suspension (FML), clobetasone butyrate 0.1% (Eumovate) and betamethasone phosphate 0.1% (Betnesol) in post-operative inflammation was studied in 60 eyes (50 patients) in a randomized trial. No significant differences were noted, although two patients required higher penetration steroids than FML or Eumovate. Betnesol seemed to have a greater tendency to cause raised intraocular pressure than FML. In this series, however, the authors are unable to comment on differences between Eumovate and Betnesol.

Topics: Aged; Betamethasone; Clinical Trials as Topic; Clobetasol; Double-Blind Method; Fluorometholone; Humans; Intraocular Pressure; Middle Aged; Postoperative Complications; Uveitis

Topics: Aged, 80 and over; Anti-Inflammatory Agents; Carcinoma, Basal Cell; Clobetasol; Dermatologic Agents; Facial Neoplasms; Humans; Male; Postoperative Complications; Scalp Dermatoses; Skin Neoplasms; Skin Transplantation

Vascularized composite allotransplantation represents as an emerging field in reconstructive surgery. However, some complications can be associated with the procedure. The authors describe a case of bone infarctions of the bilateral hip joints following the first hand allotransplantation in Taiwan. A 45-year-old man who experienced a traumatic amputation of the distal third of his forearm received a hand transplantation from a brain-dead donor. Immunosuppression included antithymocyte globulins, and bolus methylprednisolone (Solu-Medrol) was used for the induction. The maintenance therapy protocol included systemic tacrolimus, mycophenolate mofetil, and prednisone. The patient discontinued the systemic steroid 15 months after surgery. Two episodes of acute rejections were observed at 105 and 810 days after surgery. These signs disappeared after pulse therapy with Solu-Medrol, titration with tacrolimus, and topical immunosuppressive creams (tacrolimus and clobetasol). However, the patient felt pain in both hips after long periods of standing 30 months after the transplantation. A pelvic radiograph and magnetic resonance imaging revealed avascular necrosis (AVN) in both hip joints. Because of the progressive worsening of the pain, the patient underwent a decompression surgery on the left hip involving a fibula bone graft. The patient underwent a right hip hemi-arthroplasty with a bipolar prosthesis 3 months later. The patient remained in good health without major complications. These findings indicate that systemic steroids and tacrolimus might be the major predisposing factors for the induction of AVN after hand allotransplantation.

Topics: Administration, Topical; Amputation, Traumatic; Arthroplasty, Replacement, Hip; Clobetasol; Femur Head Necrosis; Forearm Injuries; Graft Rejection; Hand Injuries; Hand Transplantation; Hip; Humans; Infarction; Magnetic Resonance Imaging; Male; Middle Aged; Postoperative Complications; Tacrolimus; Vascularized Composite Allotransplantation

Everolimus is used as an immunosuppressant in renal allograft transplant rejection and in metastatic breast cancer treatment. One side effect of everolimus is stomatitis, referred to as mammalian target of rapamycin inhibitor-associated stomatitis. This side effect can affect treatment course and contribute to discontinuation of therapy or dose reduction, previously reported in the treatment of metastatic breast cancer. Here, we present a case of everolimus-associated stomatitis with a novel management method with intralesional triamcinolone that allows for continuous course of everolimus.

Topics: Administration, Topical; Anti-Inflammatory Agents; Clobetasol; Diagnosis, Differential; Everolimus; Female; Gels; Humans; Immunosuppressive Agents; Kidney Transplantation; Middle Aged; Postoperative Complications; Stomatitis

A 72-year-old woman was admitted for a routine elective total knee replacement. By day 1 postoperative, she became hyponatraemic following an Addisonian crisis, leading to an admission into the intensive therapy unit (ITU). It was later during this stay in the ITU and on a retrospective drug history review that she was found to have taken clobetasol, a high strength topical steroid cream over the past 2 years. The authors alert the reader to the importance of specially asking patients about their use of current or recent topical steroid creams as they may not always volunteer this information. Sudden withdrawal of steroid supplementation in these patients in the preoperative period may result in catastrophic consequences.

Topics: Aged; Arthroplasty, Replacement, Knee; Clobetasol; Elective Surgical Procedures; Female; Glucocorticoids; Humans; Hyponatremia; Postoperative Complications; Preoperative Care; Substance Withdrawal Syndrome

The medial canthus is a frequent site for skin cancer and reconstruction after Mohs surgery can prove to be challenging. In the literature various reconstruction methods are recommended for these cases. Flap reconstructions are mostly transposition flaps from the glabella, skin with different properties from that in the canthal region, hence mostly requiring correction in a second stage.. To ascertain the utility of a different reconstruction method, applying island pedicle flaps for medial canthal lesions and obviating the necessity for second-stage corrections.. A review was undertaken of the medical records and photographs of patients who had a pedicle island flap reconstruction for medial canthal defects after Mohs surgery. There were four different possibilities: a pedicle island flap from the cheek, the back of the nose or the glabella or a combination of these flaps.. Sixteen patients were reconstructed by pedicle island flaps for defects of the medial canthal area. A follow-up for all patients after 1 year indicated that all patients showed good to excellent results. No cases of web deformation and ectropion were found.. This flap is not mentioned in textbooks in reference to the reconstruction of canthal lesions and its value for this particular location is probably underestimated.

Topics: Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Clobetasol; Eyelid Neoplasms; Female; Follow-Up Studies; Humans; Laser Therapy; Lasers, Gas; Male; Middle Aged; Postoperative Complications; Surgical Flaps; Triamcinolone

Pyoderma gangrenosum is a rare disease characterized by chronic, nonhealing, noninfectious ulcers that can become exacerbated by trauma or manipulation, including surgical treatment. We describe the case of a 30-year-old woman who presented with a large ulcer at the site of an excisional cervical lymph node biopsy; she also had a smaller ulcer at the site of an earlier biopsy that had been previously well healed. The ulcers persisted despite local care, and the larger ulcer was exacerbated by surgical debridement. Histopathology revealed the presence of intense neutrophilic infiltrates with sterile microabscesses-a finding consistent with pyoderma gangrenosum. With 9 weeks of treatment with a high-potency topical steroid, both ulcers gradually healed.

Topics: Administration, Topical; Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Clobetasol; Female; Humans; Lupus Erythematosus, Systemic; Postoperative Complications; Pyoderma Gangrenosum; Sjogren's Syndrome; Staphylococcus aureus; Time Factors

A 53-year-old woman presented with erosive pustular dermatosis of the scalp 6 weeks after a bifrontal skin flap and right frontal craniotomy had been performed for removal of a suprasellar meningioma. Although some authors consider that acute local trauma is a precipitating factor for this condition, we believe that this is the first reported case following a neurosurgical procedure.

Topics: Clobetasol; Craniotomy; Drug Therapy, Combination; Erythromycin; Female; Humans; Middle Aged; Postoperative Complications; Scalp Dermatoses; Skin Diseases, Vesiculobullous; Surgical Flaps

Topics: Administration, Topical; Betamethasone; Clobetasol; Cryosurgery; Edema; Humans; Inflammation; Postoperative Complications