Two percent topical phenytoin sodium solution in treating pyoderma gangrenosum: a cohort study

Fonseka, Sanjeewani; Ekanayake, Sandeepa Madhujith Bandara; Dissanayake, Manel

doi:10.1111/j.1742-481x.2010.00725.x

Cited by 24 publications

(23 citation statements)

References 16 publications

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“…It is noteworthy that studies of moderate to strong evidence pointed to the analgesic effects of this drug for wounds (10) , and their authors mentioned the use of phenytoin as a secure application (10,12,15) , important factors when one is concerned about systemic absorption that application of topical phenytoin may trigger.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Scientific production on the applicability of phenytoin in wound healing

Firmino¹,

Almeida

Silva

et al. 2014

Rev. esc. enferm. USP

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RESUmoA fenitoína é um anticonvulsivante que vem sendo empregado na cicatrização de ferida. Os objetivos desta pesquisa foram: descrever como a produção científica apresenta o uso da fenitoína como agente cicatrizante e discutir sua aplicabilidade em feridas. Foi realizada, para tanto, revisão integrativa da literatura e análise pela hierarquia das práticas baseadas em evidências. Assim, analisaram-se 18 artigos que testaram a intervenção em feridas como úlceras de perna, por hanseníase, pé diabético, úlceras por pressão, tróficas, ferimentos de guerra, queimaduras, preparo da área receptora de enxerto, radiodermites e pós-extração de nevos melanocíticos. Uso sistê-mico da fenitoína no tratamento de fístulas e a hipótese do uso tópico no tratamento do vitiligo foram achados. Conclui-se que a fenitoína tópica é uma evidência científica. No entanto necessita-se de pesquisas robustas que sustentem o uso protocolar da fenitoína como mais uma opção de agente cicatrizante na prática clínica. Scientific production on the applicability of phenytoin in wound healing * CritiCal review AbStRActPhenytoin is an anticonvulsant that has been used in wound healing. The objectives of this study were to describe how the scientific production presents the use of phenytoin as a healing agent and to discuss its applicability in wounds. A literature review and hierarchy analysis of evidence-based practices was performed.Eighteen articles were analyzed that tested the intervention in wounds such as leprosy ulcers, leg ulcers, diabetic foot ulcers, pressure ulcers, trophic ulcers, war wounds, burns, preparation of recipient graft area, radiodermatitis and post-extraction of melanocytic nevi. Systemic use of phenytoin in the treatment of fistulas and the hypothesis of topical use in the treatment of vitiligo were found. In conclusion, topical use of phenytoin is scientifically evidenced. However robust research is needed that supports a protocol for the use of phenytoin as another option of a healing agent in clinical practice. dEScRiPtoRS Phenytoin Wound healing Evidence-based nursing Review RESUmEnLa fenitoína es un anticonvulsivo que se utiliza en la cicatrización de heridas. Los objetivos de esta investigación fueron: describir cómo la producción científica presenta el uso de la fenitoína como agente cicatrizante y discutir su aplicabilidad en las heridas. Se realizó una revisión integradora de la literatura y el análisis por la jerarquía de las prácticas basadas en las evidencias. Se analizaron 18 artículos que probaron la intervención en heridas como úlceras en la pierna por hanseniasis, pie diabético, úlceras por presión, tróficas, heridas de guerra, quemadura, preparación de la zona a injertar, radiodermitis y post extracción de nevos melanocíticos. Se encontró el uso sistémico de la fenitoína en el tratamiento de fístulas y la hipótesis del uso tópico en el tratamiento del vitíligo. Se concluye que la fenitoína tópica es una evidencia científica. Sin embargo, se necesita de investigaciones sólidas que sustenten el uso protocola...

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Section: Discussionmentioning

confidence: 99%

“…↓ of ulcer surfaces was higher in the study groups. Burning sensation referred by N4 (7.4%) 2/A Topical phenytoin versus eusol in the treatment of non-malignant chronic leg ulcers (10) (15) 2010 Sri Lanka Cohort study/N6…”

Section: Evidence /Recomendationmentioning

confidence: 99%

Scientific production on the applicability of phenytoin in wound healing

Firmino¹,

Almeida

Silva

et al. 2014

Rev. esc. enferm. USP

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“…Zwykle proponuje się terapię systemową połączoną z leczeniem miejscowym, stosując zewnętrznie m.in. GKS w połączeniu z antybiotykami, takrolimus, CsA, 10-procentową sulfasalazynę, azotan srebra, 1-procentowy kromoglikan sodowy [4,[7][8][9][10][11]. W terapii pierwszego rzutu wielu autorów proponuje GKS systemowe, prednizon w dawce 0,5-1,0 mg/kg m.c./dobę lub MP w dawce 0,8 mg/kg m.c./dobę doustnie, a w szybko postępu-jącym procesie chorobowym pulsy MP po 500 mg dożylnie przez 3-5 dni.…”

Section: Przypadekunclassified

Pyoderma gangrenosum, diagnostic and therapeutic difficulties – two cases imitating breast cancer

Tupikowska¹,

Kaniowski²,

Gruber³

et al. 2016

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Przegląd Dermatologiczny 2016/1 StreSzczenieWprowadzenie. Piodermia zgorzelinowa jest rzadką dermatozą o nieznanej etiologii. Zmiany skórne to szybko szerzące się, bolesne, niegoją-ce się owrzodzenia z martwiczym dnem i wałowatym brzegiem. Cel pracy. Opis dwóch chorych z piodermią zgorzelinową imitującą raka piersi i ich leczenia. Opis przypadków. U dwóch pacjentek z podejrzeniem raka piersi po zabiegu usunięcia guzków powstały niegojące się i bolesne owrzodzenia. Mimo początkowo stwierdzanych w obrazie histopatologicznym zmian mastopatycznych weryfikowano rozpoznanie, a kolejne biopsje nie wykazały obecności zmian nowotworowych. W obu przypadkach niegojące się owrzodzenia potraktowano jako infekcyjne powikłanie pooperacyjne. Rozpoznanie piodermii zgorzelinowej ustalono na podstawie charakterystycznego wywiadu, obrazu klinicznego oraz badania histologicznego. W leczeniu zastosowano cyklosporynę w połączeniu z dapsonem oraz cyklosporynę z glikokortykosteroidami i uzyskano bardzo szybką poprawę stanu miejscowego oraz ustąpienie bólu. Wnioski. Przedstawione przypadki ilustrują trudności diagnostyczne oraz rolę patergii w powstawaniu zmian w piodermii zgorzelinowej. Przebieg choroby i jej leczenie w obu przypadkach potwierdzają także nieskuteczność glikokortykosteroidów w monoterapii. AbStrActIntroduction. Pyoderma gangrenosum is a rare dermatosis with unknown etiology. Painful and quickly spreading ulcerations with necrotic bottom and heaped wound edges are typical. Objective. The aim of this study is to present patients with pyoderma gangrenosum which imitated breast cancer and their treatment. Case report. Two women suspected of having breast cancer developed painful and non-healing ulceration after surgical excision of nodules. Although in histopathology mastopathic changes were described, the diagnosis was verified and subsequent biopsies showed no cancerous changes. Ulcerations were treated as an infectious surgery complication. The diagnosis of pyoderma gangrenosum was made on the basis of characteristic anamnesis, clinical features and histopathological exaPiodermia zgorzelinowa, trudności diagnostyczne i terapeutyczne -opis dwóch przypadków imitujących raka piersi Pyoderma gangrenosum, diagnostic and therapeutic difficultiestwo cases imitating breast cancer

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“…The clinical effects of topical phenytoin on wound healing have been systematically reviewed by . Various clinical trials have reported an improved healing rate of cutaneous wounds, decubitus ulcers, diabetic foot ulcers, burn wounds, traumatic wounds and abscesses with reduced inflammation and edema (Bahmani et al, 2011;Fonseka et al, 2010;Hokkam et al, 2011;Rashidi et al, 2012;Rhodes et al, 2001). To-date, despite the extensive studies was done on the wound healing effect of topical phenytoin, it is still used as offlabel medications.…”

Section: Introductionmentioning

confidence: 99%

“…Topical phenytoin sodium suspensions (2 and 4% w/w) had been using to apply directly to the wounds. Nevertheless, the efficiencies of these formulations remained controversial due to the low contact period of phenytoin over the wounds and difficulty for even application (Rhodes et al, 2006;Almousilly et al, 2012;Fonseka et al, 2010). Thus, a novel drug carrier is needed to be developed for effective control and improved drug delivery of topical phenytoin.…”

Section: Introductionmentioning

confidence: 99%

Lipid-Based Delivery System for Topical Phenytoin

Lee¹,

Pung²,

Khor³

et al. 2016

J App Pharm Sci

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The wound healing effect of topical phenytoin has been reported but its effective delivery system is still underresearched. The present work aimed to formulate topical lipid-based gels for effective delivery of phenytoin. Three lipid-based emulsions with different droplet sizes were prepared using coconut kernel oil (CKO) and soybean oil (SBO) blends as an oil phase. Stable lipid-based emulsion with 100% emulsion stability index (ESI) over seven heating/cooling cycles could only be formed when the oil droplet satisfied the nano size criterion, as demonstrated by nano-emulsion. The stability of macro-emulsion and cream could be enhanced by the addition of Aristoflex ammonium acryloyldimethyl-taurate/VP (AVC) copolymer as the gelling agent. These gels, designated as nano-emulgel, macro-emulgel and cream-gel, were subsequently loaded with phenytoin. All gels exhibited non-Newtonian and shear-thinning flow behavior, with high yield stress ranged 18.8 -51.5 Pa. The in vitro drug release profiles of all formulations followed the first-order kinetic model, with R 2 > 0.95. It was found that lipid nano-emulgel demonstrated the highest release rate of phenytoin, with 93.12% drug released in 12 hours, followed by cream-gel with 56.42% and macro-emulgel with 51.51%. CKO/SBO nano-emulgel was identified as the most suitable lipid topical gel formulation for effective delivery of phenytoin.

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Two percent topical phenytoin sodium solution in treating pyoderma gangrenosum: a cohort study

Cited by 24 publications

References 16 publications

Scientific production on the applicability of phenytoin in wound healing

Scientific production on the applicability of phenytoin in wound healing

Pyoderma gangrenosum, diagnostic and therapeutic difficulties – two cases imitating breast cancer

Lipid-Based Delivery System for Topical Phenytoin

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