Notice bibliographique
Résumé
BACKGROUND: Intralesional steroid (ILS; usually triamcinolone acetonide) is commonly used, and the literature contains much information about its use in keloids, hemangiomas, and alopecia areata. Little has been written about its use in inflammatory dermatoses such as psoriasis and localized dermatitis since the 1960s, the conditions for which it was originally most studied and used. OBJECTIVE: To clarify the use of ILS and to encourage its use in psoriasis and localized dermatitis. METHODS: Medline peer-reviewed literature in English (1956-2008) was searched for the use of ILS in all skin diseases. Six standard textbooks of dermatology were reviewed. Information as to how they used ILS was obtained from a questionnaire completed by 33 dermatologists and from personal discussions with 15 other dermatologists. Additional information was obtained from 40 years of personal ILS use and from observation of 42 dermatologists working intermittently in our office over the past 25 years. ILS product package inserts and company drug monographs were reviewed. RESULTS: ILS is used by most dermatologists, but there are considerable divergences in technique and dosing. Current textbooks contain little on its use in psoriasis and localized dermatitis. There have been no clinical studies since the 1960s, and their end points and descriptions were somewhat vague by today's standards. Product package inserts are dated and not helpful. Nevertheless, the use of ILS is safe and economical, and the original authors and our office have found it consistently to be virtually 100% effective at 2.5 mg/mL in small plaques of psoriasis on the trunk and limbs and highly effective in localized dermatitis (such as lichen simplex chronicus, prurigo nodularis, and nonspecific eczema). Clinical studies indicate that we can safely increase our ILS from the usual 3 cc (7.5 mg) to 6 cc (15 mg) or even to 8 cc (20 mg) for patients over 50 kg every 3 to 4 weeks. Serum cortisol can be performed if there are concerns about adrenal suppression, with use in periorbital hemangiomas and with intranasal ILS. Blindness (from central artery occlusion) was reported with injections of ILS around the eyes wih older products during the early development stages; and more recently with the use of ILS for periorbital hemangiomas and with ILS used intranasally. It has never been reported with low pressure injections of ILS using triamcinalone acetonide at 2.5 mg around the eyes. LIMITATIONS: No formal clinical studies since the 1960s. Poor statistical end points. CONCLUSIONS: ILS at 2.5 mg/cc is safe, economical, and effective and its greater use should be encouraged in inflammatory dermatoses such as psoriasis and localized dermatitis. Further well-designed research would be helpful.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».