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      Criocirurgia com nitrogênio líquido e as dermatoses infecciosas Translated title: Cryosurgery using liquid nitrogen and infectious skin diseases

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          Abstract

          A criocirurgia com nitrogênio líquido é recurso cirúrgico utilizado para o tratamento de várias lesões cutâneas, benignas, pré-malignas e malignas. Promove destruição dos tecidos acometidos por congelamento e alterações da resposta imunológica. Os autores enfocam a utilização da criocirurgia no tratamento das dermatoses infecciosas, principalmente as verrugas virais, leishmaniose e ccromoblastomicose. Discutem os resultados como tratamento primário ou coadjuvante. O artigo também apresenta os cuidados com os instrumentos no tratamento das doenças infecciosas.

          Translated abstract

          Cryosurgery using liquid nitrogen is a surgical resource to treat several types of benign, pre-malignant and malignant skin lesions. It promotes the destruction of tissues and changes the immune response. The authors identify several uses of cryosurgery in treating skin disorders, particularly viral warts, chromoblastomycosis and leishmaniasis. The results of primary and adjuvant treatments are also discussed. The article focuses on precautions when using surgical instruments during treatment of infectious diseases.

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          Most cited references41

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          Cutaneous warts: an evidence-based approach to therapy.

          Rocky Bacelieri, Candace Johnson (2005)
          Cutaneous warts are a common presenting complaint in children and adolescents. Common, plantar, or flat warts are cutaneous manifestations of the human papillomavirus. The treatment of warts poses a therapeutic challenge for physicians. No single therapy has been proven effective at achieving complete remission in every patient. As a result, many different approaches to wart therapy exist. These approaches are discussed to demonstrate the evidence supporting common therapies and provide a guideline for physicians. Evidence supports the at-home use of topical salicylic acid and physician-administered cryotherapy. Intralesional immunotherapy for nongenital cutaneous warts may be an option for large or recalcitrant warts.
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            Cryosurgery updated

            Emanuel Kuflik (1994)
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              Treatment of chromoblastomycosis with itraconazole, cryosurgery, and a combination of both.

              E Gerard, Alma E. Martínez, A Bonifaz … (1997)
              Chromoblastomycosis is a subcutaneous mycosis, seen frequently in tropical areas, and caused by dematiaceous fungi. It produces nodulo-verrucous lesions in the arms and legs. There is no treatment of choice for this disease and sometimes a combination of chemotherapy and physical therapy is necessary. The study included 12 patients diagnosed with chromoblastomycosis by means of fungal and histopathologic tests. The patients were assigned to three treatment groups: patients with small lesions, not greater than 15 cm2 in area, were assigned to Group 1, in which the treatment consisted of itraconazole 300 mg/day, or to Group 2, in which the treatment consisted of one or more sessions of open-spray cryosurgery. Patients with large lesions were assigned to Group 3 and started treatment with itraconazole 300 mg/day, until a maximal reduction of lesions occurred, and then underwent one or several cryosurgery sessions. Clinical, fungal, and laboratory tests were performed in each group before, during, and at the completion of treatment. Positive cultures of Fonsecaea pedrosoi were obtained in 11 out of 12 patients. Two out of four patients in Groups 1 and 3 had a clinical and fungal cure and the remaining patients experienced significant improvement. All four patients included in Group 2 achieved a cure. No important side-effects were seen among the patients included in any of the two itraconazole groups, and only two out of eight patients reported gastric discomfort. The cryosurgery group reported only normal complications of the process, such as edema and pain; two out of eight patients had a superimposed infection. The results of itraconazole and cryosurgery were good in cases with small lesions; antifungal therapy being more appropriate for flexion areas. The combination of itraconazole, to reduce the size of the lesions, with subsequent treatment of the remaining lesions with cryosurgery, represents a new alternative in the treatment of patients with large lesions. Both types of therapy are considered safe, with few side-effects.
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                Author and article information

                Journal
                Journal ID (publisher-id): abd
                Title: Anais Brasileiros de Dermatologia
                Abbreviated Title: An. Bras. Dermatol.
                Publisher: Sociedade Brasileira de Dermatologia (Rio de Janeiro, RJ, Brazil )
                ISSN (Print): 0365-0596
                ISSN (Electronic): 1806-4841
                Publication date (Print and electronic): August 2008
                Volume: 83
                Issue: 4
                Pages: 285-298
                Affiliations
                [05] Campinas SP orgnameUniversidade Estadual de Campinas orgdiv1Hospital das Clínicas orgdiv2Faculdade de Ciências Médicas Brasil
                [03] orgnameUniversidade Estadual de Campinas orgdiv1Faculdade de Ciências Médicas
                [02] Campinas SP orgnameUniversidade Estadual de Campinas orgdiv1Hospital das Clínicas orgdiv2Divisão de Clínica Dermatológica Brasil
                [04] Campinas SP orgnameUniversidade Estadual de Campinas orgdiv1Hospital das Clínicas orgdiv2Divisão de Clínica Dermatológica Brasil
                [01] orgnameUniversidade Estadual de Campinas orgdiv1Faculdade de Ciências Médicas
                Article
                Publisher ID: S0365-05962008000400002 Publisher ID: S0365-0596(08)08300402
                SO-VID: eceefd1b-45b5-4bac-b847-7b5ab78b2730
                License:

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                Date received : 12 August 2008
                Date accepted : 12 August 2008
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 47, Pages: 14
                Product

                SciELO Brazil

                Categories
                Subject: Educação Médica Continuada - EMC

                Keywords: Criocirurgia,Leishmaniasis,Human papillomavirus 6,Chromoblastomycosis,Skin diseases,Cryosurgery,Papillomavirus 6 humano,Leishmaniose,Dermatopatias,Cromoblastomicose
                Data availability:
                Keywords: Criocirurgia, Leishmaniasis, Human papillomavirus 6, Chromoblastomycosis, Skin diseases, Cryosurgery, Papillomavirus 6 humano, Leishmaniose, Dermatopatias, Cromoblastomicose

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