Vulvar Pyoderma Gangrenosum in a Child

Garcovich, S.; Gatto, Antonio; Ferrara, Pietro; Garcovich, A

doi:10.1111/j.1525-1470.2009.01005.x

Cited by 27 publications

(9 citation statements)

References 5 publications

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“…Several studies have demonstrated decreased secretion of ADH and a reduced response to antidiuretic hormone in children affected. Moreover, NE may be present with several comorbidities such as sleep disorders, psychological problems, parasomnias, left-handedness, polythelia, language disorders and testicular pathology (8)(9)(10). Various formulations of dDAVP are available (tablets, nasal spray) and many studies also showed that the dosage for MELT is more predictable due to the significantly smaller variance, however there is only limited information on the response to dDAVP in children relative to the dose required to produce an antidiuretic effect for the entire night.…”

Section: Discussionmentioning

confidence: 99%

Desmopressin 120 mcg, 180 mcg, 240 mcg: The right treatment for the right patient

Ferrara

Vescovo

Ianniello

et al. 2018

Arch Ital Urol Androl

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Background: The first-line drug therapy for patients with nocturnal enuresis (NE) associated with nocturnal polyuria and normal bladder function is desmopressin (dDAVP). Objective: To evaluate if increasing dose of oral desmopressin lyophilisate (MELT) can improve response rates to dDAVP and is useful in enuretic children. Materials and methods: We enrolled a total of 260 children all diagnosed with NE. Enuretic children were treated with increasing MELT at a dose of 120, 180 and 240 mcg a day. Results. We included in our study a total of 237 children, 164 males (69.2%) and 73 females (30.8%) aged between 5 and 18 years (mean age 10.32 ± 2.52 years). Of the 237 patients enrolled in the study and treated with MELT 120 mcg, a full response was achieved in 135 (56.9%). A partial response was achieved in 21 (8.9%) patients, therefore the dose was increased up to 180 mcg, with further improving symptoms (14.3%) or full response (9.5%), and up to 240 mcg, without usefulness. Conclusions: MELT at the dose of 120 mcg resulted efficacy and safety; the increased dose up to 180 mcg resulted poorly efficacy; finally, the further increase up to 240 mcg did not improve the symptoms with the increased risk of side effects.KEY WORDS: Desmopressin; Nocturnal enuresis. ated with nocturnal polyuria and normal bladder function is desmopressin (dDAVP) for a period of 3 months following by withdrawal. dDAVP is associated with a response rate of about 40-60%, however its effect may not be maintained on discontinuing treatment, and symptoms have been found to recur in about 50-80% after stopping treatment (3). The different formulations of dDAVP are an intranasal solution, an oral tablet formulation and the recent oral sublingual lyophilisate (MELT). The aim of this study is to evaluate if increasing dose of MELT (120, 180, 240 mcg/day) can improve response rates to dDAVP in enuretic children. MATERIALS AND METHODSWe enrolled a total of 260 children all diagnosed with NE, between April 2014 and April 2017, at the Paediatric Service of Campus Bio-Medico Hospital in Rome. Inclusion criteria were: age > 5 years and a diagnosis of primary MNE (PMNE) without NE treatment in the last 3 months. Exclusion criteria were the presence of secondary NE, any provided story of urinary infection, nephrogenic diabetes or congenital genitourinary anomalies. The children and their families were asked to participate in the study. This study was conducted in accordance with the regulatory standards of Good Clinical Practice and the Declaration of Helsinki. We carefully evaluated each patients with medical history and physical examination, including monitoring blood pressure, possible sign of spinal dysraphism or polythelia, neurological reflexes and genital examination. During the period of treatment, all patients and their parents were asked to keep a NE calendar depicting the wet and the dry nights and in addition, we educated both child and parents with dietary advices (4). During the follow-up, families were called to verify their adherence and respons...

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Section: Discussionmentioning

confidence: 99%

Desmopressin 120 mcg, 180 mcg, 240 mcg: The right treatment for the right patient

Ferrara

Vescovo

Ianniello

et al. 2018

Arch Ital Urol Androl

Self Cite

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“…Immediate and intensive care for these children and their family is essential. (23)(24)(25)(26)(27)(28)(29) Black and colleagues, as a result of their experience with these troubled children, suggested some recommendations that include: immediately after the killing, children's placement should be with familiar people; primary health care services should be alerted about the children and early consultations sought from child mental health services; expert advice should be sought regarding the possibility of attending their mother's funeral and of visiting their father. (9) In the longer term, permanent placement planning should begin as soon as possible: the emergency placement should not become permanent by default; therapeutic help should be available as needed, especially for children who witnessed the killing.…”

Section: Resultsmentioning

confidence: 99%

Murdered women’s children: A social emergency and gloomy reality

Ferrara

Ianniello

Semeraro

et al. 2018

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“…Hier passieren die meisten Anpralltraumen. Auch Unterarme, Schulter, Genitale und Brustbereich sind mögliche Lokalisationen [10,17].…”

Section: Chirurgische Therapie Beim Pyoderma Gangraenosumunclassified

Chirurgische Therapie beim Pyoderma gangraenosum

2011

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Pyoderma gangrenosum is a rare affection of unknown etiology, which is often associated with systemic diseases such as chronic inflammatory bowel disease, hematologic disorders, carcinomas and arthritis. Treatment may include topical corticosteroids or calcineurin inhibitors in combination with systemic corticosteroids, cyclosporine A, azathioprine, cyclophosphamide, mycophenolate mofetil, intravenous immunoglobulins or monoclonal antibodies against TNFα but all these approaches are off-label. Surgical therapy is difficult because of pathergy. Nevertheless, after having stopped the inflammation, the ulcers can be treated by split thickness skin grafts and simultaneous immunosuppression. We present three cases with successful surgical treatment.

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Vulvar Pyoderma Gangrenosum in a Child

Cited by 27 publications

References 5 publications

Desmopressin 120 mcg, 180 mcg, 240 mcg: The right treatment for the right patient

Desmopressin 120 mcg, 180 mcg, 240 mcg: The right treatment for the right patient

Murdered women’s children: A social emergency and gloomy reality

Chirurgische Therapie beim Pyoderma gangraenosum

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