1.
Isolated nail lichen planus: An expert consensus on treatment of the classical form.
Iorizzo, M, Tosti, A, Starace, M, Baran, R, Daniel, CR, Di Chiacchio, N, Goettmann, S, Grover, C, Haneke, E, Lipner, SR, et al
Journal of the American Academy of Dermatology. 2020;(6):1717-1723
Abstract
Lichen planus is a benign inflammatory disorder of unknown etiology that may affect the skin, mucosae, scalp, and nails. When the nails are affected, it may lead to permanent destruction with severe functional and psychosocial consequences. Therefore, prompt diagnosis and early treatment are essential, even in mild cases. There are currently no guidelines for the management of nail lichen planus and the published literature on treatment is limited. The aim of this review is to provide practical management recommendations for the classical form of nail lichen planus, especially when restricted to the nails. Topical treatment has poor short-term efficacy and may cause long-term side effects. Instead, intralesional and intramuscular triamcinolone acetonide should be considered first-line therapies. Oral retinoids are second-line choices, and immunosuppressive agents may also be considered.
2.
Diabetic macular edema.
Bandello, F, Battaglia Parodi, M, Lanzetta, P, Loewenstein, A, Massin, P, Menchini, F, Veritti, D
Developments in ophthalmology. 2010;:73-110
Abstract
Diabetic macular edema (DME), defined as a retinal thickening involving or approaching the center of the macula, represents the most common cause of vision loss in patients affected by diabetes mellitus. In the last few years, many diagnostic tools have been proven useful in the detection and the monitoring of the features characterizing DME. On the other hand, several therapeutic approaches can now be proposed on the basis of the DME-specific characteristics. The aim of the present chapter is to thoroughly delineate the clinical and morpho functional characteristics of DME and its current treatment perspectives. The pathogenesis and the course of DME require a complex approach with multidisciplinary intervention both at the systemic and local levels.
3.
Steroid injection in addition to macular laser grid photocoagulation in diabetic macular oedema: a systematic review.
Steijns, D, Duijvesz, D, Breedijk, MA, van der Heijden, GJ
Acta ophthalmologica. 2010;(4):389-93
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Abstract
OBJECTIVES This study aimed to evaluate the evidence for the effects of steroid injection in addition to macular laser grid (MLG) photocoagulation versus those of MLG photocoagulation alone on visual acuity (VA) in patients with diabetic macular oedema (DMO). METHODS An extensive literature search in Medline (PubMed), Experta Medica (EMBASE) and the Cochrane Library (CENTRAL) using synonyms for MLG photocoagulation, steroid injection and DMO found 181 articles. Of the articles that met selection criteria, three studies in which patients receiving MLG photocoagulation were randomized to additional pretreatment with steroids provided the best available evidence. In addition to VA, central foveal thickness (CFT) was measured at baseline and at 6 months in all three studies. RESULTS Two studies, with total populations of 73 and 42 eyes, respectively, reported no additional effect of steroid injection on VA. One study, with a total of 41 eyes, reported a beneficial effect of pretreatment with steroids on VA of -0.21 ETDRS logMAR units. All three studies reported larger reductions in CFT in eyes pretreated with steroids, the smallest of which was 64 microm. CONCLUSIONS Although there is a greater reduction in CFT in eyes pretreated with steroids, this does not consistently result in higher VA. The literature search does not provide sufficiently strong evidence to recommend steroid injection before MLG photocoagulation in DMO.