psd-502 and Skin-Neoplasms

The control of pain associated with laser treatment of port-wine stains in children has been problematic. Using EMLA, a topical anesthetic, children can be treated with a significant reduction in laser-induced pain. In this prospective, double-blind, placebo-controlled, randomized trial of EMLA, 73 children (35 boys and 38 girls) ranging in age from 5 to 16 years with port-wine stains were treated. EMLA reduced mean pain scores 66% when compared with control subjects (p < 0.0001 for all three assessments of pain). Concordance between evaluators' and patients' assessment of pain scores correlated strongly (p < 0.001). Treatment with EMLA abolished pain in 40% of patients and the percentage of pain-free treatments increased from 10% to 52% (p < 0.001). EMLA is clearly effective in reducing or eliminating pain associated with laser treatment of port-wine stains in children.

Topics: Administration, Cutaneous; Adolescent; Anesthesia, Local; Anesthetics, Local; Child; Child, Preschool; Drug Combinations; Female; Hemangioma; Humans; Laser Therapy; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Prilocaine; Skin Neoplasms

Superficial basal cell carcinomas of the skin (sBCC) often respond poorly to single-treatment aminolaevulinic acid-based photodynamic therapy (ALA-PDT), with a number of reports indicating a relapse rate of 50% or more.. To determine whether a second treatment at seven days can improve the response.. Twenty-six lesions were treated twice with ALA-PDT, with an interval of 7 days between the two treatment sessions.. We observed a complete response rate of 100% 1 month after treatment. Only one lesion relapsed (16 months post-PDT), a relapse rate of 4% (median follow up 27 months; range 15-45 months). Cosmetic results were excellent.. We consider routine double treatments with ALA-PDT to be an effective approach to the management of sBCC, particularly those located in anatomically difficult, or cosmetically sensitive, sites.

Topics: Administration, Cutaneous; Aged; Aminolevulinic Acid; Carcinoma, Basal Cell; Follow-Up Studies; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Microscopy, Fluorescence; Middle Aged; Ointments; Photochemotherapy; Photosensitizing Agents; Prilocaine; Skin Neoplasms

To assess the efficacy of the topical anesthetic cream, EMLA, in alleviating the pain produced by infiltration of local anesthetic prior to surgical skin biopsies, a randomized, double-blind, placebo-controlled study was performed on 54 patients undergoing 162 excisional biopsies. Both pain induced by needle insertion and pain induced by local injection were significantly diminished after topical application of EMLA cream. However, part of the effect was placebo, because the placebo ointment (Vaseline) also produced significant pain alleviation.

Topics: Adult; Anesthesia, Local; Anesthetics, Local; Biopsy; Drug Combinations; Female; Humans; Injections; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Pain Measurement; Prilocaine; Skin; Skin Neoplasms; Treatment Outcome

Vascular-specific lasers with pulse durations of between 300 and 500 microseconds are the treatment of choice for portwine stains (PWS), particularly in children. Although the discomfort felt following laser irradiation from a single pulse is transient, these sensations are intensified when multiple pulses are delivered over a confined area of skin. Because 75-80% of PWS are located in the head and neck regions, laser treatment of these sites tends to be more painful than those located in most other parts of the body. A prospective double blind randomized study, assessing pain during laser irradiation on PWS skin occluded with either EMLA, placebo, or no cream (control) was performed in 73 PWS subjects between 5 and 16 years of age. Analysis of the data showed that the pain scores for EMLA-treated sites were the smallest, the control scores tended to be the highest, with the placebo scores in the middle. The differences between the treatments were significant (P < 0.0001).

Topics: Adolescent; Anesthetics, Local; Child; Child, Preschool; Double-Blind Method; Drug Combinations; Female; Hemangioma; Humans; Laser Therapy; Lasers; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Pain Measurement; Prilocaine; Prospective Studies; Skin Neoplasms

Topics: Anesthesia, General; Anesthesia, Local; Child; Child, Preschool; Facial Neoplasms; Hemangioma; Humans; Infant; Infant, Newborn; Lidocaine; Lidocaine, Prilocaine Drug Combination; Patient Compliance; Prilocaine; Risk Factors; Skin Neoplasms

Topics: Anesthetics, Local; Drug Combinations; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Mycosis Fungoides; Pain, Intractable; Prilocaine; Skin Neoplasms

Topics: Anesthesia, Local; Anesthetics, Combined; Female; Hemangioma; Humans; Infant, Newborn; Lidocaine; Lidocaine, Prilocaine Drug Combination; Methemoglobinemia; Prilocaine; Skin Neoplasms

Topics: Anesthetics, Local; Child; Drug Combinations; Female; Hemangioma; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Ointments; Prilocaine; Skin Neoplasms

EMLA cream (Eutectic Mixture of Local Anesthetics) is a new topical anesthetic composed of 25 mg lidocaine and 25 mg prilocaine in an oil-in-water emulsion cream. It has been found to be very effective for local anesthesia prior to venepuncture, minor surgical procedures, and pulsed dye laser (PDL) therapy for port-wine stains (PWS) in children. However, since EMLA may cause vasoconstriction of cutaneous vessels, we tried to determine whether pretreatment with EMLA decreases the efficacy of subsequent PDL treatment. We report eight patients between the ages of 4 and 32 years with PWS who received two test site treatments prior to PDL treatment. One site was pretreated with EMLA cream under occlusion for 60 minutes and then left unoccluded for 15 minutes prior to PDL test treatment. The other site, in the same area of the PWS and patient's body, was not pretreated with EMLA. The test sites were compared 6-8 weeks later to determine whether EMLA decreased the degree of lightening of the PWS compared to the non-EMLA-treated site. We conclude that EMLA is an effective topical anesthetic for PDL treatment of PWS and does not adversely affect the efficacy of the treatment.

Topics: Administration, Topical; Adolescent; Adult; Anesthetics, Local; Child; Child, Preschool; Drug Combinations; Female; Hemangioma; Humans; Laser Therapy; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Pain; Prilocaine; Skin Neoplasms

Using an percutaneous anesthetic Lidocaine ointment (EMLA cream 5%), we treated patients with mollusca contagiosa, condylomata acuminata, and verrucae plantaris by superficial curettage or electrocaustic surgery. The same presurgical procedure was applied in taking biopsies from the glans penis. The analgesia achieved was complete in all patients with mollusca contagiosa, condylomata acuminata, and penal biopsies. In those with verrucae plantaris, the anesthesia was incomplete but tolerable, also in children. We discuss the pharmacological effects of and further indications for this new percutaneous anesthetic ointment.

Topics: Anesthetics, Local; Biopsy; Condylomata Acuminata; Drug Combinations; Electrocoagulation; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Molluscum Contagiosum; Ointments; Penile Neoplasms; Prilocaine; Skin Diseases; Skin Neoplasms; Warts