Ann Med Res 2020;27(8):2225-6
2225
Annals of Medical Research DOI:10.5455/annalsmedres.2020.02.146
Thursday, March 26, 2020
Friday, March 13, 2020
Pilonidal Disease Can Be Treated By Dermatologists With Crystallized Phenol In Outpatient Clinics
Pilonidal Disease Can Be Treated By Dermatologists With Crystallized Phenol In Outpatient Clinics
Journal of the College of Physicians and Surgeons Pakistan
Pilonidal disease, hidradenitis suppurativa, acne conglobata, and dissecting cellulitis of the scalp are the members of follicular occlusion tetrad with similar pathophysiology, which is initiated by follicular occlusion in apocrine gland bearing areas.1 Interestingly, while the treatment of hidradenitis suppurativa, acne conglobata, and dissecting cellulitis has been undertaken by dermatologists, the treatment of pilonidal disease has been left to general surgeons. However, pilonidal disease can also be treated by dermatologists with crystallised phenol using a minimally invasive technique in outpatient clinics.2 Hereby, we would like to explain crystallised phenol technique in detail in order to encourage dermatologists to treat pilonidal disease. The detailed visual description of crystallised phenol technique in the treatment of pilonidal disease is depicted in Figure 1.
The treatment of pilonidal disease with crystallised phenol has many advantages. This technique is minimally invasive; moreover, learning curve is extremely short. Only one-time application is enough to learn the whole procedure. There is no need for operating room settings. Dermatologists can apply crystallised phenol to their patients with pilonidal sinus in their outpatient clinics. Furthermore, patients can get to work after the procedure immediately. Possible postoperative complications, such mild pain, purulent discharge, and abscess formation, can be treated with non-steroidal anti-inflammatory drugs and antibiotics.2 Moreover, referring the patient to a general surgeon is always an available option.
The post-treatment cosmetic results are excellent, as there are no incisions or stitches after the procedure. Phenol treatment has a 30-40% failure rate with multiple and suppurative pilonidal disease. However, patients who have limited disease (1-3 pilonidal pits) have higher success rates.3 Our two-year follow-up of 50 patients with pilonidal disease treated with one-time application of crystallised phenol revealed 80% complete healing rate. Therefore, we encourage our dermatology specialist colleagues to treat patients diagnosed with pilonidal disease with crystallised phenol in their outpatient clinics.
Does Vitamin D Deficiency Cause Direct Inguinal Hernia? Preliminary Results
D Vitamini Eksikliği Direkt İnguinal Herni Oluşmasına Neden Olur Mu? Ön
Sonuçlar
Acıbadem Üniversitesi Sağlık Bilimleri Dergisi
The main reason for the inguinal hernia
development is the degenerative changes of the lower abdominal muscles that
weaken the muscle strength. Myocyte atrophy, fibrosis and fatty degeneration in
the internal inguinal ring area and the abdominal wall have been demonstrated
previously (9). As the weakness in the connective tissue or muscles of the
patient leads to an inguinal hernia, we suggest that decreased vitamin D levels
may be associated with the development of a direct inguinal hernia. In our
study, the patients with direct inguinal hernia had lower serum 25(OH)D levels
(23.11±8.42) than in healthy individuals (24.77±10.67). There was no
statistically significant difference in vitamin D levels in both groups
(p=0.77). However, low vitamin D levels were more frequent in patients with
inguinal hernia compared to healthy individuals. Twenty-seven (90%) patients
with inguinal hernia had serum vitamin D levels under 30 ng/mL, while 21 (70%)
healthy individuals had serumvitamin D levels under 30 ng/mL. The risk of
vitamin D deficiency increases by age as in inguinal hernia development (7, 9).
Our study demonstrated that low serum 25(OH)D levels are common in elderly
patients with direct inguinal hernia.
Conclusion: Decreased levels of vitamin D may facilitate the development of an
inguinal hernia. Our results revealed that low serum vitamin D levels are more
common in patients with direct inguinal hernia compared to healthy individuals.
However, there was no statistically significant difference between the two
groups. Therefore, the vitamin D status of a larger sample group should be
evaluated in order to reach a definitive conclusion.
Pilonidal disease specimens of 905 patients revealed no malignancy, however we still insist on histopathological examination
Mehmet Eren Yuksel 1, Melike Ordu
2
1
Ankara Yildirim Beyazit University, Faculty of Medicine, Intensive Care Unit,
Ankara, Turkey
2 Aksaray University Training and Research Hospital, Clinic of Pathology, Aksaray, Turkey
2 Aksaray University Training and Research Hospital, Clinic of Pathology, Aksaray, Turkey
Copyright
© 2020 by authors and Annals of Medical Research Publishing Inc.
Abstract
Aim:
Pilonidal disease presents with acute abscess, sinuses, pits and scarring in
the sacrococcygeal region. Surgical intervention is one of the treatment
options of pilonidal disease. However, it has been a matter of debate, whether
histological analysis of surgically resected pilonidal disease specimens would
be necessary.
Material
and Methods: Medical records of the patients with pilonidal disease who
underwent either primary excision and closure or modified Limberg flap surgery
were reviewed retrospectively. The results of the histopathological examination
of the pilonidal disease specimens were evaluated.
Results:
This study included 905 patients (686 male and 219 female) with pilonidal
disease who were treated with surgical intervention. The mean age of the
patients was 23.96±7.5 years. All surgically excised pilonidal disease
specimens of the patients were histopathologically evaluated in order to rule
out malignancy. No malignancy was detected.
Conclusion:
We conducted a Pubmed search with the term “pilonidal” between January 2000 and
March 2019. We identified 91 patients with malignant degeneration arising on
pilonidal disease in the English medical literature. The most common pilonidal
disease associated malignancy was squamous cell carcinoma. Even it is rare,
malignancy may accompany pilonidal disease. Therefore, even we have not
encountered any malignancy in 905 patients with pilonidal disease, we still
insist on histopathological examination of all surgically resected pilonidal
disease specimens in order to rule out malignancy.
Keywords:
Histopathological examination; malignancy; pilonidal disease; squamous cell
carcinoma
Crystallized phenol treatment is less effective in patients with recurrent pilonidal disease after surgery compared to patients with primary pilonidal disease
Mehmet Eren Yuksel
Ankara Yildirim Beyazit University, Faculty of Medicine, Intensive Care Unit,
Ankara, Turkey
Copyright © 2020 by authors and Annals of Medical Research Publishing Inc.
Abstract
Aim: Primary pilonidal disease can be treated with crystallized phenol with
an overall cure rate of 80%. However, the effect of crystallized phenol in
patients who had recurrence after pilonidal disease surgery has not been
analyzed in the English medical literature in detail yet. The purpose of this
study was to investigate the effect of crystallized phenol in recurrent
pilonidal disease.
Material and Methods: 28 male and 10 female patients who had recurrence after surgical intervention to treat pilonidal disease were evaluated. Twenty male and 8 female patients underwent excision and primary closure surgery, whereas 8 male patients and 2 female patients underwent modified Limberg flap surgery. All of these 38 patients were treated with one-time application of crystallized phenol.
Results: The mean period for recurrence of patients treated with single application of crystallized phenol after primary excision and primary closure surgery was 45.85±11.82 days (range: 35-90 days) and it was 66.5±25.31 days (range: 40-120 days) after modified Limberg flap surgery. The follow-up period was 6 months. The cure rate in recurrent excision and primary closure group was 57.14%, whereas the cure rate in the recurrent modified Limberg flap group was 40%. Overall cure rate was 52.63%.
Conclusion: As a result, crystallized phenol treatment was less effective in patients who had recurrence after pilonidal disease surgery in comparison to patients who were only treated with crystallized phenol without prior surgical intervention.
Keywords: Crystallized phenol; pilonidal disease; recurrence
https://www.annalsmedres.org/articles-and-issues/current-issues/item/1464-crystallized-phenol-treatment-is-less-effective-in-patients-with-recurrent-pilonidal-disease-after-surgery-compared-to-patients-with-primary-pilonidal-disease-p-830-2.htmlMaterial and Methods: 28 male and 10 female patients who had recurrence after surgical intervention to treat pilonidal disease were evaluated. Twenty male and 8 female patients underwent excision and primary closure surgery, whereas 8 male patients and 2 female patients underwent modified Limberg flap surgery. All of these 38 patients were treated with one-time application of crystallized phenol.
Results: The mean period for recurrence of patients treated with single application of crystallized phenol after primary excision and primary closure surgery was 45.85±11.82 days (range: 35-90 days) and it was 66.5±25.31 days (range: 40-120 days) after modified Limberg flap surgery. The follow-up period was 6 months. The cure rate in recurrent excision and primary closure group was 57.14%, whereas the cure rate in the recurrent modified Limberg flap group was 40%. Overall cure rate was 52.63%.
Conclusion: As a result, crystallized phenol treatment was less effective in patients who had recurrence after pilonidal disease surgery in comparison to patients who were only treated with crystallized phenol without prior surgical intervention.
Keywords: Crystallized phenol; pilonidal disease; recurrence
Tuesday, March 03, 2020
Pre-treatment vitamin B12, folate, ferritin, and vitamin D serum levels in patients with warts: a retrospective study
Aim To compare the serum levels of 25-hydroxyvitamin
D, ferritin, folate, vitamin B12, zinc, and thyroid stimulating
hormone between patients with warts and healthy individuals.
Methods This retrospective study enrolled 40 patients
with warts and 40 healthy individuals treated at the Ufuk
University Hospital, Ankara, between July and December
2017. Serum levels of 25-hydroxyvitamin D, ferritin, folate,
vitamin B12, zinc, and thyroid stimulating hormone status
were evaluated retrospectively.
Results Participants with and without warts had similar mean serum 25-hydroxyvitamin D, ferritin, folate, zinc,
and thyroid stimulating hormone levels. However, patients
with warts had significantly lower mean serum vitamin B12
level (P=0.010). Patients with warts non-significantly more
frequently had decreased serum levels of 25-hydroxyvitamin D, ferritin, and folate (P=0.330, P=0.200, P=0.070, respectively).
Conclusion Patients with warts may require evaluation of
serum levels of vitamin B12, folate, ferritin, and vitamin D.
Pre-treatment vitamin B12, folate, ferritin, and vitamin D serum levels in patients with warts: a retrospective study
Funda Tamer, Mehmet Eren Yuksel, Yavuz KarabagCMJ 2020; 61: 28-32
Full Text - PDF
http://www.cmj.hr/default.aspx?id=13105&issue=yes
Full Text - PDF
http://www.cmj.hr/default.aspx?id=13105&issue=yes
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