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PubMed2003

Retrospective analysis of sentinel node localization in multifocal, multicentric, palpable, or nonpalpable breast cancer.

UNLABELLED: Multicentric or multifocal breast cancer is considered as one of the limitations for sentinel lymph node (SLN) localization. We did a retrospective analysis to evaluate the success rate, sensitivity, accuracy, and negative predictive values of SLN localization in multicentric or multifocal breast lesions. METHODS: Fifty-nine patients with multifocal or multicentric breast lesions proven by either fine-needle aspiration (19/59), core biopsy (39/59), or lumpectomy (8/59) underwent SLN localization. Of these patients, 46 had SLN localization by both radiocolloid and blue dye, and 13 had SLN localization by radiocolloid alone. Approximately 10 MBq (99m)Tc-labeled unfiltered sulfur colloid in 0.3-0.4 mL were injected intradermally over the 1 or 2 breast tumor locations 2-4 h before surgery. During surgery, vital blue dye was injected intraparenchymally in 4-6 places around the tumor. All lymph nodes with counts of >10 times that of the background counts, whether or not blue dye positive, and all blue dye-positive lymph nodes, whether or not radiocolloid positive, were excised and labeled accordingly. All lymph nodes underwent frozen sectioning and were examined by hematoxylin and eosin and immunohistologic (cytokeratin) staining. RESULTS: Of the 59 patients, 48 had axillary lymph node dissection irrespective of the results of pathologic examination of the SLN. The success rate, sensitivity, negative predictive value, and accuracy were 93%, 100%, 100%, and 100% using the radiocolloid probe, 87%, 100%, 100%, and 100% using blue dye, and 93.5%, 100%, 100%, and 100% using combined methods, respectively. Concordance between blue dye and radiocolloid was 91% (the incidence of the number of sentinel nodes detected was 37.5%, 30.3%, 10.7%, and 21.4% for 1, 2, 3, and 4 or more lymph nodes, respectively). Metastatic lymph node involvement was found in 39.5% of patients. CONCLUSION: The sentinel node localization approach showed a high negative predictive value in breast cancer patients with multifocal or multicentric lesions, contrary to the common belief of significant false-negative results in these patients.

Adult↗
PubMed1983

Rejection of retrovirus-infected tumor cells in guinea pigs: effect on bystander tumor cells.

We studied the basis of rejection of retrovirus-infected tumor cells in guinea pigs by evaluating host response to injection of mixtures containing retrovirus-infected tumor cells and, antigenically and biologically distinct, uninfected tumor cells (line 10). After intradermal injection, line 10 grew progressively, metastasized to regional lymph nodes, and led to death of animals; line 107C3 4070A, a murine leukemia virus-infected fibrosarcoma cell line, grew for approximately 1 week and then regressed. Growth of the line 10 hepatoma was suppressed when the hepatoma cells were mixed with viable 107C3 4070A cells before injection into strain 2 guinea pigs. Viable virus-infected 107C3 cells were more effective than irradiated virus-infected cells in suppressing line 10 growth; mixture of line 10 with murine leukemia virus 4070A alone did not inhibit line 10 growth. Suppression of growth of line 10 cells by admixed murine leukemia virus 4070A-infected cells was less effective in animals with established viral immunity. Cyclophosphamide inhibited suppression of line 10 at sites of injection of virus-infected cells. Infection of line 10 with murine leukemia virus in vitro required cocultivation of line 10 cells with murine leukemia virus-infected fibrosarcoma cells; virus alone did not lead to acquisition of murine leukemia virus antigens by line 10 cells.

Animals↗
PubMed1978

Photoallergic urticaria induced by visible light. Additional cases and further studies.

Four patients with solar urticaria induced by visible light developed an urticarial wheal at the site of injection of their own serum, which previously had been exposed to light in vitro. The in vitro-irradiated patients' sera did not produce the urticarial response in normal control subjects. Direct passive transfer studies with the patients' sera yeilded positive results, while reverse passive transfer studies showed negative results. Based on the experimental data, the patients' conditions might be induced by an allergic mechanism in which a circulating photoallergen appears to be an etiologic factor. One of the patients demonstrated an urticarial reaction at the site of injection of in vitro-irradiated normal serum as well as his own serum. The urticaria formation was blocked by intradermal injection of epinephrine but not by local injection of antihistamines. The repeated exposures to light had a beneficial effect on wheal formation in all cases.

Adult↗
PubMed1993

Skin anti-inflammatory activity of apigenin-7-glucoside in rats.

The effect of apigenin-7-glucoside on skin inflammation induced by different generators of reactive oxygen species and free radicals was studied. Skin inflammation in rats was induced by intradermal injection of glucose-oxidase (hydrogen peroxide), xanthine-oxidase/hypoxanthine (superoxide anion radical), and cumene hydroperoxide (peroxyl radical). Subsequent intradermal application of liposomal apigenin-7-glucoside inhibited in a dose dependent manner skin inflammation caused by xanthine-oxidase and cumene hydroperoxide. Glucose-oxidase induced dermatitis was not significantly inhibited. The results are in good agreement with the in-vitro superoxide anion radical and peroxyl radical scavenging properties of apigenin and indicate that its antioxidant properties contribute to the anti-inflammatory effect in this model system.

Animals↗
PubMed2001

Mast cells play a key role in neutrophil recruitment in experimental bullous pemphigoid.

Bullous pemphigoid (BP) is an inflammatory subepidermal blistering disease associated with an IgG autoimmune response to the hemidesmosomal protein BP180. Passive transfer of antibodies to the murine BP180 (mBP180) ectodomain triggers a blistering skin disease in mice that depends on complement activation and neutrophil infiltration and closely mimics human BP. In the present study, we show that mast cells (MCs) play a crucial role in experimental BP. Wild-type mice injected intradermally with pathogenic anti-mBP180 IgG exhibited extensive MC degranulation in skin, which preceded neutrophil infiltration and subsequent subepidermal blistering. In contrast, mice genetically deficient in MCs or MC-sufficient mice pretreated with an inhibitor of MC degranulation failed to develop BP. Further, MC-deficient mice reconstituted in skin with MCs became susceptible to experimental BP. Despite the activation of complement to yield C3a and C5a, in the absence of MCs, accumulation of neutrophils at the injection site was blunted. The lack of response due to MC deficiency was overcome by intradermal administration of a neutrophil chemoattractant, IL-8, or by reconstitution of the injection sites with neutrophils. These findings provide the first direct evidence to our knowledge that MCs play an essential role in neutrophil recruitment during subepidermal blister formation in experimental BP.

Animals↗
PubMed2004

Intradermal methylene blue injection for the treatment of intractable idiopathic pruritus ani: results of 30 cases.

Some cases of idiopathic pruritus anu may be refractory to treatment with dietary and hygienic instructions and short-term topical medications. In this study, we documented our technique and results with methylene blue injection in a large series of patients with intractable idiopathic pruritus ani. The results of 30 adult patients with well-documented intractable idiopathic pruritus ani who were treated with intradermal methylene blue injection are reported. No antibiotic prophylaxis, anesthesia or sedation was used. A total of 15 ml of a 1% methylene blue solution was injected intracutaneously and subcutaneously in the affected perianal area. A second injection (rescue treatment) was offered one month later to patients who declared partial response, and follow-up was restarted. One month after injection, 24 patients (80%) were symptom-free, 5 declared partial remissions, and one patient still had the same degree of pruritus ani. Five patients with partial remission underwent a second methylene blue injection, which provided complete relief in four. Therefore, the early response rate was 80% with single injection and 93.3% (28 of 30) with the rescue treatment. At six months, three recurrences were noted, indicating to a success rate of 83.3% (25 of 30). At 12 months after treatment, 23 patients (76.7%) were symptom free. This study has shown that intradermal methylene blue injection is a safe, simple, fast and efficient method of treating intractable idiopathic pruritus ani.

Adult↗
PubMed1997

Optimal selective sentinel lymph node dissection in primary malignant melanoma.

OBJECTIVE: To determine the optimal approach of selective sentinel lymph node (SLN) dissection in primary malignant melanoma. DESIGN: Consecutive patient study. Prior to selective SLN dissection and wide local excision of the primary melanoma biopsy site, technetium Tc 99m sulfur colloid was injected intradermally around the primary melanoma or biopsy site to mark the SLN. Isosulfan blue (Lymphazurin, Hirsch Industries Inc, Richmond, Va) was injected at the primary biopsy site immediately before the surgical procedure. SETTING: Teaching hospital tertiary care referral center. MAIN OUTCOME MEASURES: Successful identification of SLNs being defined as positive for microscopic metastatic melanoma by blue dye staining, radioisotope uptake, or both. RESULTS: Selective intraoperative mapping by gamma probe and visualization of blue dye-stained SLN(s) resulted in a 98% (160/163) successful identification rate. Thirty patients (18.4%) had microscopic metastatic melanoma of the SLN(s), 22 of whom had subsequently completed lymphadenectomy. In 4 (18.2%) of these 22 patients, further microscopic metastatic disease was found in 1 of 8 nodes, 1 of 8 nodes, 1 of 28 nodes, and 1 of 9 nodes. No notable complications were encountered. Five recurrent cases from patients with SLNs without microscopic metastatic melanoma (3.8%) and 2 from patients with SLNs with microscopic metastatic melanoma (6%) were found during a median follow-up period of 463 days. A second primary melanoma developed in 2 patients; neither had no local recurrence. CONCLUSIONS: Sequential combination of preoperative lymphoscintigraphy and intraoperative mapping is a reliable way to identify regional SLN. The frequency of microscopic metastatic melanoma of the SLN(s) is 18.4%. Gamma-probe--guided resection minimizes the extent of lymph node dissection. Further follow-up is needed to assess the outcome of this group of patients for regional and systemic recurrences.

Adult↗
PubMed1982

Skin response to intradermal DNA and RNA in systemic lupus erythematosus.

The local response of 18 patients with active systemic lupus erythematosus to 0.1 ml of intradermally injected 0.1% polymerized calf thymus DNA and synthetic double-stranded polyinosinic-polycytidylic acid was studied. In 14 patients positive for DNA, 61 +/- 8% of the inflammatory cells in the subepidermis at 24 hours were acid alpha-naphthyl acetate esterase-positive T lymphocytes. A leukocytoclastic vasculitis was observed in the deeper dermis. Rheumatoid arthritis patients and acne patients had negative responses. These results indicated an abnormal cellular and humoral in vivo response by patients with systemic lupus to DNA. It is suggested that the epidermal Langerhans cells were responsible for the topographic dichotomy of the local DNA response. Test results were positive for polyinosinic-polycytidylic acid in 12 patients, for DNA in 14 patients, and for both in 9 patients. In the 9 patients with positive results for both tests, comparison of responses to each test indicated that the reaction intensity was dependent on the patient and not on the type of polynucleotide acid that was injected.

DNA↗
PubMed1994

Is immune function better preserved after laparoscopic versus open colon resection?

The purpose of this preliminary study was to evaluate immunologic responses to laparoscopic vs standard open colon resection and to evaluate possible mediators of any differences found. Specifically, we compared cortisol levels and delayed-type hypersensitivity response after each method of colon resection in a group of 20 pigs. Two groups of 10 animals each were treated in identical fashion including bowel preparation, anesthesia, and postoperative management. The only difference between groups was that one underwent laparoscopic and the other an open colon resection. Blood specimens for cortisol were drawn before, during, and immediately postoperatively as well as at 11 A.M. on postoperative days 1 and 2. All animals had been previously immunized as piglets with Sow Bac-E (Oxford Veterinary, Worthington, MN), an antigen preparation of common pig pathogens. At the conclusion of the operative procedure 0.5 cc of the antigen was injected intradermally on the right forelimb of the animals. At 48 and 72 h postoperatively the largest diameters of induration surrounding the injection site were measured and averaged. Cortisol levels were measured in serum samples by radioimmunoassay (Met-Path, Rockville, MD). Statistical significance was determined by t-test. Results of skin antigen testing showed that the group of pigs that underwent laparoscopic resection had a 20% greater response, 1.54 cm +/- 0.28 cm at 48 h and 1.53 cm +/- 0.18 cm at 72 h. For the open-surgery group results were 1.24 cm +/- 0.26 cm at 48 h and 1.32 cm +/- 0.21 cm at 72 h, P < 0.05 for the difference between groups at both 48 and 72 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1981

Resistance to cutaneous leishmaniasis in genetically susceptible BALB/c mice.

When injected cutaneously with promastigotes of an isolate of Leishmania tropica, BALB/c mice develop progressive cutaneous disease whereas lesions in BALB/c.H-2k mice heal after several weeks. Lesions in BALB/c mice injected into deep subcutaneous tissues with promastigotes are less obvious early but much more prominent later than in mice after strict intradermal injection. BALB/c mice injected with Corynebacterium parvum together with a preparation of frozen and thawed infected macrophages are more resistant to cutaneous disease than mice injected with either adjuvant or crude antigen mixture alone. Results of these experiments, and those on other mouse strains reported previously, will aid in the choice of mouse and injection regime to be used in testing the efficacy of isolated L. tropica antigens as vaccines.

Animals↗
PubMed2000

Comparison of genetically engineered hypoallergenic rBet v 1 derivatives with rBet v 1 wild-type by skin prick and intradermal testing: results obtained in a French population.

BACKGROUND: Bet v 1, the major allergen in birch pollen, is recognized by more than 90% of patients allergic to birch in northern and central Europe. Immunotherapy is commonly performed with birch pollen extracts. Recently, hypoallergenic derivatives of Bet v 1 (rBet v 1 fragments, rBet v 1 dimer and trimer) were constructed and purified. OBJECTIVE: Our aim was to compare the allergenic activity of wild-type rBet v 1 with recombinant Bet v 1 derivatives (rBet v 1 fragments, dimer and trimer) with potentially reduced anaphylactic activity by skin testing in a French population. METHODS: Among the 36 birch pollen allergic patients included in the study, 29 were tested by skin prick testing and 30 by intradermal injections with purified monosubstances: rBet v 1 fragments (F1: aa1-74 and F2: aa75-160), Bet v 1 dimer and trimer. Intradermal tests were performed by the end-point intradermal titration method. Eight of the intradermally-tested patients were previously hyposensitized. Tests were performed over a period of 6 months (before, during and after birch pollen season); Bet v 1-specific IgE and IgG4 subclass responses were measured by immunoblotting and ELISA. RESULTS: All patients showed lower reactivity with the modified rBet v 1 allergens, both in skin prick and intradermal tests. In 25 and 23 out of 29 patients the lowest concentration of fragment 1 and 2, respectively, resulting in a positive prick test was 100-fold higher than the lowest concentration of monomer resulting in a positive prick test. For dimer it was 100-fold or more in 25 out of 29 patients, and for trimer it was 100-fold or superior in 26 out of 29 patients. By intradermal testing, the end-point concentration was 160-fold higher for trimer than for monomer in 24 patients and 40-fold higher in five patients. For the two fragments the end-point concentration was 160-fold higher in 20 out of 22 patients. CONCLUSION: Genetically modified hypoallergenic derivatives of the major birch pollen allergen, Bet v 1 showed reduced capacity to induce immediate type skin reactions. They may represent candidate molecules for immunotherapy of birch pollen allergy with reduced risk of anaphylactic side-effects.

Adolescent↗
PubMed1999

Skin testing with wild-type recombinant birch pollen allergens and hypoallergenic modified molecules.

UNLABELLED: Our aim was to compare the allergenic activity of wild type rBet v 1 with recombinant Bet v 1 derivatives (rBet v 1 fragments, dimer and trimer) with potentially reduced anaphylactic activity by skin testing in a French population. METHODS: Among the 36 birch pollen allergic patients included in the study, 29 were tested by skin prick testing and 30 by intradermal injections with purified monosubstances: rBet v 1 fragments (F1: aa1-74 and F2: aa75-160), Bet v 1 dimer and trimer. Intradermal tests were performed by the endpoint intradermal titration method. Tests were performed over a period of 6 months (before, during and after birch pollen season). RESULTS: All patients showed lower reactivity with the modified rBet v 1 allergens, both in skin prick- and intradermal tests. In 25 and 23 out of 29 patients the lowest concentration of fragment 1 and 2 respectively, resulting in a positive prick test was 100 fold higher than the lowest concentration of monomer resulting in a positive prick test. For dimer it was 100 fold or more in 25 out of 29 patients, and for trimer it was 100 fold or superior in 26 out of 29 patients. By intradermal testing, the end point concentration was 160 fold higher for trimer than for monomer in 24 patients and 40 fold higher in 5 patients. For the 2 fragments the end point concentration was 160 fold higher in 20 out of 22 patients. CONCLUSION: rBet v 1 fragments and trimer may represent candidate molecules for immunotherapy of birch pollen allergy with reduced risk of anaphylactic side effects.

Allergens↗
PubMed1991

The sequential generation of neutrophil chemoattractant proteins in acute inflammation in the rabbit in vivo. Relationship between C5a and proteins with the characteristics of IL-8/neutrophil-activating protein 1.

An in vivo experimental peritonitis model was investigated in the rabbit using zymosan as the inflammatory stimulus. After an i.p. injection of zymosan, exudate was removed at intervals and tested in the back skin of assay rabbits. Assay rabbits received i.v. injections of 125I-albumin and 111In-neutrophils, and the local accumulation of each label was measured in response to intradermal injections of exudate samples mixed with a potentiating dose of PGE2. When peritoneal exudate samples were tested in the presence of a specific anti-C5a antibody, virtually all the edema-inducing and neutrophil chemoattractant activity was abolished in samples taken up to 2 h after the zymosan injection. Later samples, however, contained increasing levels of a non-C5a component. In C5a-depleted 6-h exudate two peaks of inflammatory activity were separated using cation exchange HPLC. Evidence is presented that C5a itself is unable to stimulate the production of these activities. Both peaks of activity appear related to IL-8/NAP-1 as they inhibited the binding of 125I-IL-8/NAP-1 to human neutrophils.

Acute-Phase Reaction↗
PubMed1988

Elicitation of bovine antibody to BLV-gp51 by BLV-vaccination.

This study was carried out to demonstrate sequential changes of antibody response to gp51 of BLV in bovine hosts injected with BLV-vaccine. BLV vaccine was prepared from culture fluids from FLK-BLV cells by treatment with 0.1% formalin for 48 hrs at 4 degrees C followed by ultrafiltration and lyophilization. Sterile vaccine containing 300 mg protein/ml, 1 mg of which was reactive by ELISA with monoclonal anti-BLV-glycopeptide up to 1:256 dilution, was injected intradermally with Freund's adjuvant into two 1-month-old Holstein calves seronegative for BLV. The first and second booster injections were given without adjuvant 3 and 15 weeks, respectively, after the initial injection. Sera collected weekly from these animals were analyzed to monitor development of antibody to BLV-gp51 by Western blotting and immunoferritin electron microscopy, as well as by ELISA to whole BLV and to BLV-gp51 partially purified by column chromatography. Antibody to BLV-gp51 was detected in sera collected 2 weeks after the initial injection, increased 2 weeks after the first booster, maintained its level during the following 10 weeks, and increased again 2 weeks after the second booster injection. Infectious BLV was not detected by syncytium-formation assay of lymphocytes collected 15 weeks after the initial injection. This study demonstrated sequential changes of anti-BLV-gp51 antibody elicited in bovine hosts subsequent to injection of formalin-treated BLV. Further analysis of bovine antibody to BLV-gp51 may help develop improved BLV-vaccine.

Animals↗
PubMed1987

Double-blind study on antitissue immunoglobulin injections versus placebo in the treatment of acute lumbar pain with muscular spasms.

A double-blind study was carried out on antitissue immunoglobulins (Sérocytol Neuro-Vasculaire) administered by intradermal injections to 44 patients (24 women, 20 men; age range 36-76 years) suffering from acute lumbar pain accompanied by muscular spasms. In the treated group of 21 patients, excellent or good results were recorded in 14 cases (67%) and moderate results or no effect in 7 (33%). The mean number of injections necessary was 3.7 per patient. Injections were given every four days. In the placebo group of 20 patients (an addition 3 having dropped out), excellent or good results were obtained in 6 cases (30%) and moderate results or no effect in 14 (70%). The mean number of injections required was 4.6 per patient. The parameters considered included pain (night wakings, spontaneous pain and pain on pressure) and mobility (Schober's index, distance from fingertips to ground, extension, lateroflexion). The investigating physician's evaluation of the efficacy of antitissue immunoglobulins was similar to that of the patients. Tolerance of the product was excellent in all cases.

Acute Disease↗
PubMed1987

Role for macrophage products in endotoxin-induced polymorphonuclear leukocyte accumulation during inflammation.

Endotoxins (lipopolysaccharide, LPS) released by Gram-negative bacteria induce acute inflammation with polymorphonuclear leukocyte (PMNL) infiltration. The mechanism of PMNL accumulation appears to be complement-independent and is not well understood. Here, we report investigation of the factors which may mediate LPS-induced PMNL accumulation in the pleural cavity and skin of rabbits. The intrapleural injection of 50 ng of Escherichia coli 0111 LPS caused the appearance in the exudate fluid of an activity which, upon intradermal injection induced PMNL accumulation in the skin, as measured by a 51Cr-labeled leukocyte assay and which was confirmed histologically. This activity preceded by 30 minutes the massive influx of PMNL into the pleural cavity. 125I-labeled LPS, gel filtration chromatography, limulus amebocyte lysate assays, and polymyxin B allowed distinction between reactions in the skin attributable to LPS and reactions due to the effect of this "PMNL infiltration-inducing activity." Pleural macrophages cultured for 3 to 6 hours with 3 to 30 ng/ml of LPS also released factors which induced PMNL infiltration into the skin. Sephadex G-100 chromatography of LPS-induced pleural exudate fluid or of supernatants from LPS-stimulated macrophage cultures yielded identical elution profiles, with one major peak of PMNL infiltration-inducing activity at an apparent molecular weight of 45,000 and a minor peak at 14,000 to 18,000. Only the low molecular weight fraction contained interleukin 1 activity. Lipid A was required for the secretion of these factors by macrophages. The LPS shed by killed E. coli also induced macrophage production of PMNL infiltration-inducing activity. The activity was sensitive to pronase, and its production was inhibited by an inhibitor of protein synthesis (cycloheximide). The active factors did not induce PMNL chemotaxis, aggregation, or chemiluminescence in vitro indicating that the activity was not C5a. We conclude that PMNL infiltration induced by LPS and perhaps by Gram-negative bacteria, may be mediated in part by the secretion from tissue macrophages of factors which can recruit PMNLs from the blood. The most active of these (approximately equal to 45,000 daltons) lacks interleukin-1 or PMNL chemotactic activity.

Animals↗
PubMed2006

Everolimus (RAD) inhibits in vivo growth of murine squamous cell carcinoma (SCC VII).

OBJECTIVE: Everolimus (RAD) is an mTOR inhibitor closely related to rapamycin. A potent immunosuppressive agent, it has also shown evidence of antineoplastic properties. SCC VII is a spontaneously arising murine squamous cell carcinoma line. This study examines the effect of everolimus on SCC VII proliferation. The data may provide support for the use of everolimus in transplant recipients with a history of malignancy. METHODS: A dose efficacy study was conducted that used a murine model of intradermal tumor growth and pulmonary metastases. The development of intradermal tumors and pulmonary metastases were studied. Of 80 total mice, 40 received intradermal injection of 1 x 10 SCC VII cells and 40 received intravenous injection of 1 x 10 cells to establish pulmonary metastases. Within each group, animals were subdivided into four subgroups that received 1) 1 mg/kg everolimus twice a day, 2) 0.5 mg/kg everolimus twice a day, 3) 7.5 mg/kg cyclosporine per day, and 4) no treatment. Intradermal tumors were measured three times per week. Animals receiving an intravenous tumor injection were killed after 17 days and pulmonary metastases were quantified. Medication trough levels were measured in all treated animals. RESULTS: Everolimus showed statistically significant tumor inhibition at 1.0 mg/kg twice a day and 0.5 mg/kg twice a day when compared with animals treated with cyclosporine and with untreated animals (P < .0001). Tumor inhibition was evident in both models studied (intradermal tumors and pulmonary metastasis generation). CONCLUSIONS: Everolimus provides potent tumor inhibition in animals inoculated with SCC VII cells. Inhibition of both local and distant spread of disease is evident. Although most immunosuppressives are known to potentiate neoplastic disease, this study supports the use of everolimus immunosuppression in the face of prior malignancy. This data has significant implication for laryngeal transplantation after laryngectomy.

Animals↗
PubMed1976

Treatment of zoster and postzoster neuralgia by the intralesional injection of triamcinolone: a computer analysis of 199 cases.

On the basis of this study of 111 patients with herpes zoster and 88 with postherpetic neuralgia, it is suggested that the intradermal injection of triamcinolone in saline is a valuable treatment. Mild complications were pain, hemorrhage, abscesses, atrophy, moon face and possibly thrombophlebitis. Zoster patients required treatment for about half as long as those in previously reported control series. In patients treated for active herpes zoster, postzoster neuralgia occurred with about one-third of the frequency noted in other series. In postzoster neuralgia, the patient was benefited sufficiently in 62.5% of the cases to find that life was worth living again.

Adolescent↗