Our experience with intralesional corticosteroid injection therapy for infantile adnexal hemangiomao

Bonavolont, G.; Vassallo, Patrizia; Uccello, Giovanni; Tranfa, Fausto

doi:10.3109/01676838509014433

Cited by 8 publications

(1 citation statement)

References 9 publications

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“…However, the bulk of reports noting local postinjection complications following drug injections are limited to only specifying the main active ingredient and its single dose (triamcinolone, betamethasone phosphate sodium, methylprednisolone, dexamethasone [34][35][36][37][38][39][40][41][42][43]. There are also many other reports in which the quantitative and qualitative characteristics of drugs injected that caused local complications are incomplete and inaccurate [44-46].…”

Section: Controlled and Uncontrolled Physical-chemical Properties Of ...mentioning

confidence: 99%

Post-injection Complications. Nicolau Syndrome as a Consequence of Local Irritant Effects of Drugs, Including Antiseptics, Local Anesthetics, NSAIDs, Steroids and Anticoagulants

Urakov

Уракова

Fisher

et al. 2022

JPRI

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It has been shown that some drugs considered to be of good quality today can cause an iatrogenic disease known as Nicolau syndrome. Nicolau syndrome is a rare cutaneous drug reaction occurring after injection many drugs. This disease has been found to be caused by the very strong local irritant activity of drug solutions. It turned out that the standard for assessing the quality of drug solutions does not include assessment of their osmotic activity and the strength of their local irritating effect on various tissues during injection. At the same time, drug solutions produced by different pharmaceutical companies may contain, in addition to the main ingredients, other ingredients (hydrochloric acid, sodium hydroxide, propylene glycol, etc.). Very often the additional ingredients increase the osmotic activity of the drug solution, which is not controlled today, so it remains unknown. This is why drug solutions produced by some pharmaceutical companies can have hypertonic activity, which can sometimes by ignorance reach values that are incompatible with the vital activity of human body tissue cells. Therefore, injections of such drug solutions can have a very strong dehydrating effect on the tissue cells at the injection sites, have a local irritating and cauterizing effect. It has been shown that even steroid solutions in some manufacturers may have excessive hypertonic and acidic activity, which gives them a local irritating effect. This is why in some cases the injection of a steroid solution does not eliminate, but rather increases local inflammation and causes necrosis. Therefore, to exclude postinjection necroses and abscesses, it is proposed to include an assessment of the osmotic activity and local irritant effect of drug solutions in the drug quality control standard and to prohibit the injection of drug solutions with excessive hypertonic activity.

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Section: Controlled and Uncontrolled Physical-chemical Properties Of ...mentioning

confidence: 99%

Post-injection Complications. Nicolau Syndrome as a Consequence of Local Irritant Effects of Drugs, Including Antiseptics, Local Anesthetics, NSAIDs, Steroids and Anticoagulants

Urakov

Уракова

Fisher

et al. 2022

JPRI

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Normalisation of asymmetric astigmatism after intralesional steroid injection for upper eye lid hemangioma in childhood

Langmann

Lindner

1994

Doc Ophthalmol

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Infantile hemangiomas affect about 5% (3%-8%) of the population, showing a predilection for the face. After a phase of rapid enlargement between the 3rd and the 9th month of life, 70% regress by the age of six after a period of stability. 43%-60% of the children with eye lid hemangiomas develop strabismic, anisometropic, or deprivation amblyopia. Previous studies found the majority of cases resulting from anisometropia (especially asymmetric astigmatism) rather than strabism or occlusion of the visual axis. Several methods of treatment--surgical excision, irradiation, sclerosing agents, systemic steroids, ligation, cryotherapy--have been used but all with a risk of local or systemic complications. Local injections of steroids are a simple method of therapy with a high rate of resolution of hemangiomas, but still with a high degree of bad visual output because of persistent astigmatism. In four children with asymmetric astigmatism (axis of astigmatism towards the hemangioma) in which the injection was given at the beginning of the phase of enlargement, amblyopia could be avoided by preventing corneal steepening from becoming permanent.

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Capillary hemangioma (infantile periocular hemangioma)

Haik

Karcioglu

Gordon

et al. 1994

Survey of Ophthalmology

181

111

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Our experience with intralesional corticosteroid injection therapy for infantile adnexal hemangiomao

Cited by 8 publications

References 9 publications

Post-injection Complications. Nicolau Syndrome as a Consequence of Local Irritant Effects of Drugs, Including Antiseptics, Local Anesthetics, NSAIDs, Steroids and Anticoagulants

Post-injection Complications. Nicolau Syndrome as a Consequence of Local Irritant Effects of Drugs, Including Antiseptics, Local Anesthetics, NSAIDs, Steroids and Anticoagulants

Normalisation of asymmetric astigmatism after intralesional steroid injection for upper eye lid hemangioma in childhood

Capillary hemangioma (infantile periocular hemangioma)

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