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Soto-Moreno A, Cuenca-Barrales C, Arias-Santiago S, García-Vidal JA, Medina-Mirapeix F, Molina-Leyva A. Safety and Effectiveness of Percutaneous Ultrasound-Guided Galvanic Current in Tunnels of Patients with Hidradenitis Suppurativa: A Pilot Study. Dermatol Ther (Heidelb) 2024; 14:1115-1125. [PMID: 38676840 PMCID: PMC11116326 DOI: 10.1007/s13555-024-01149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/22/2024] [Indexed: 04/29/2024] Open
Abstract
INTRODUCTION The recurrent nature of hidradenitis suppurativa (HS), even under maintained systemic treatment, makes it necessary to have effective local treatments; however, the response to these therapies is variable (44-81%). The application of galvanic current (GC) has demonstrated its utility in humans in treating lesions structurally similar to those of HS. With this background, the main objective of this study was to evaluate the efficacy and safety of ultrasound-guided percutaneous GC in inflamed and/or draining tunnels of HS. METHODS This was an open study (one-way repeated measures design over time). Patients were evaluated at 4 and 12 weeks after receiving GC. A combined clinical response at week 12 (absence of suppuration/inflammation on examination and clinical interview) was considered the principal variable of efficacy. Adverse effects potentially associated with GC were reported by telephone and at each visit. RESULTS Twenty-six patients were included, with a male/female ratio of 5:8. The mean age was 35.84 (13.14) years. At 12 weeks after the administration of GC, a complete response was achieved in 77% (20/26) of the treated lesions. No serious adverse effects were observed, and the mean procedural pain assessed by the numeric rating scale was 0.03 (0.2). CONCLUSION GC has proven to be effective and well tolerated in inflamed and draining tunnels of patients with HS.
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Affiliation(s)
- Alberto Soto-Moreno
- Department of Dermatology, Hidradenitis Suppurativa Unit, Hospital Universitario Virgen de las Nieves, Fuerzas Armadas Avenue, Number 15, 18012, Granada, Spain
| | - Carlos Cuenca-Barrales
- Department of Dermatology, Hidradenitis Suppurativa Unit, Hospital Universitario Virgen de las Nieves, Fuerzas Armadas Avenue, Number 15, 18012, Granada, Spain.
- TECe19-Dermatología Clínica y Traslacional, Granada Institute for Biosanitary Research, Granada, Spain.
| | - Salvador Arias-Santiago
- Department of Dermatology, Hidradenitis Suppurativa Unit, Hospital Universitario Virgen de las Nieves, Fuerzas Armadas Avenue, Number 15, 18012, Granada, Spain
- TECe19-Dermatología Clínica y Traslacional, Granada Institute for Biosanitary Research, Granada, Spain
| | | | | | - Alejandro Molina-Leyva
- Department of Dermatology, Hidradenitis Suppurativa Unit, Hospital Universitario Virgen de las Nieves, Fuerzas Armadas Avenue, Number 15, 18012, Granada, Spain
- TECe19-Dermatología Clínica y Traslacional, Granada Institute for Biosanitary Research, Granada, Spain
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Barker C, Duff D, Wine Lee L. Hidradenitis suppurativa presenting as mammillary fistula in a teenage girl. Pediatr Dermatol 2023; 40:958-959. [PMID: 37114523 DOI: 10.1111/pde.15319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/26/2023] [Indexed: 04/29/2023]
Abstract
Hidradenitis suppurativa (HS) is a common skin disease in children and young adults. In this report, we describe an unusual case of HS presenting as a mammillary fistula (MF) in a teenage female. A thorough dermatologic history and exam resulted in diagnosis of HS. Identifying the underlying disease is key to appropriate treatment of a relapsing MF in the setting of HS.
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Affiliation(s)
- Catherine Barker
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - David Duff
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Lara Wine Lee
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Asensio-Olea L, Leirós-Rodríguez R, Marqués-Sánchez MP, de Carvalho FO, Maciel LYS. Efficacy of percutaneous electrolysis for the treatment of tendinopathies: A systematic review and meta-analysis. Clin Rehabil 2022; 37:747-759. [PMID: 36583575 DOI: 10.1177/02692155221144272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the efficacy of percutaneous electrolysis for the treatment of patients with tendinopathies. DATA SOURCES A systematic search of publications was conducted in Pubmed, Cinahl, Medline, Scopus and Web of Science. METHODS The Oxford 2011 Levels of Evidence and the Jadad scale were used to assess the quality of studies. The mean and standard deviation were obtained for each study group and used to calculate the effect size. The DerSimonian and Laird method was used to develop a random-effects model. RESULTS Of the 14 articles, four applied percutaneous electrolysis to the knee, three to the shoulder, three to the elbow, two to the hip and two to the ankle and foot. A meta-analysis on intensity of pain (evaluated with algometer and the Visual Analogue Scale) was performed on studies comparing percutaneous electrolysis with a control group, indicating that the groups treated with percutaneous electrolysis had better results (p = 0.01). Although percutaneous electrolysis did not overcome the analgesic effect achieved by corticosteroid injections. CONCLUSIONS The percutaneous electrolysis is effective for the treatment of tendinopathies. The combination of this technique with eccentric training has proven to be one of the most effective treatments to date for improving pain. PROSPERO Registration: CRD42021230005.
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Affiliation(s)
- Laura Asensio-Olea
- Nursing and Physical Therapy Department, University of Leon, Ponferrada, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Ponferrada, Spain
| | - Mª Pilar Marqués-Sánchez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Ponferrada, Spain
| | | | - Leonardo Y S Maciel
- Physical Therapy Department of Lagarto, 74391Universidade Federal de Sergipe, São José, Lagarto, Brazil.,Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
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Martínez-Silván D, Santomé-Martínez F, Champón-Chekroun AM, Velázquez-Saornil J, Gómez-Merino S, Cos-Morera MA, Morral-Fernández A, Mascaró-Vilella A, Ricis-Guerra M, García-Bol F, Posada-Franco V, Sebastiá V, Cano-Herrera C, Ramírez-Parenteau C. Clinical use of percutaneous needle electrolysis in musculoskeletal injuries: A critical and systematic review of the literature. APUNTS SPORTS MEDICINE 2022. [DOI: 10.1016/j.apunsm.2022.100396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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García-Vidal JA, Salinas J, Ortega N, Escolar-Reina P, Camacho-Alonso F, Medina-Mirapeix F. In vitro bacteriological effect of tri-beveled needle electrolysis against Staphylococcus aureus. Sci Rep 2022; 12:11468. [PMID: 35794164 PMCID: PMC9259664 DOI: 10.1038/s41598-022-15666-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022] Open
Abstract
Percutaneous needle electrolysis using tri-beveled needles with a specific protocol (5 mA applied for 25 s) has demonstrated to provoke a clinical reduction of recurrent bacterial infections in mammary fistulas. However, the bactericidal effect of needle electrolysis in this pathology remains theoretical. This in vitro study evaluated the bactericidal effect of this protocol and whether it changed when introducing small variations. Staphylococcus aureus were generated in saline solution (9 Log10 CFU/mL) and treated in three different experiments including the main protocol and introducing variations in needle gauge, intensity, and total dosage, respectively. After 24 h, the viable cell count showed that the protocol had an average reduction of 5 log10 CFU/ml compared to the control group. While variations in needle gauge did not modify this effect, variations in current intensity or dosage did. This study demonstrated that the bacterial effect was greater by increasing either current intensity or total dosage, and it decreased with substantial reductions of these parameters.
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Affiliation(s)
- José Antonio García-Vidal
- Department of Physiotherapy, University of Murcia, Campus de Espinardo, 30100, Murcia, Spain. .,Research Group Fisioterapia y Discapacidad, Institute of Biomedical Research (IMIB)-Virgen de la Arrixaca University Clinical Hospital, 30120, El Palmar, Murcia, Spain.
| | - Jesús Salinas
- Department of Animal Health, Faculty of Veterinary, University of Murcia, Campus de Espinardo, 30100, Murcia, Spain
| | - Nieves Ortega
- Department of Animal Health, Faculty of Veterinary, University of Murcia, Campus de Espinardo, 30100, Murcia, Spain
| | - Pilar Escolar-Reina
- Department of Physiotherapy, University of Murcia, Campus de Espinardo, 30100, Murcia, Spain.,Research Group Fisioterapia y Discapacidad, Institute of Biomedical Research (IMIB)-Virgen de la Arrixaca University Clinical Hospital, 30120, El Palmar, Murcia, Spain
| | - Fabio Camacho-Alonso
- Department of General Dentistry and Implants, Faculty of Medicine and Dentistry, University of Murcia, 30008, Murcia, Spain
| | - Francesc Medina-Mirapeix
- Department of Physiotherapy, University of Murcia, Campus de Espinardo, 30100, Murcia, Spain.,Research Group Fisioterapia y Discapacidad, Institute of Biomedical Research (IMIB)-Virgen de la Arrixaca University Clinical Hospital, 30120, El Palmar, Murcia, Spain
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Galvanic current dosage and bacterial concentration are determinants of the bactericidal effect of percutaneous needle electrolysis: an in vitro study. Sci Rep 2021; 11:18977. [PMID: 34556763 PMCID: PMC8460800 DOI: 10.1038/s41598-021-98451-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 08/30/2021] [Indexed: 01/29/2023] Open
Abstract
Percutaneous needle electrolysis (PNE) is a physiotherapy technique that has been shown to be effective in different pathologies such as tendinopathies or mammary fistula. For many years, theoretical bactericidal and germicidal effects have been attributed to this type of galvanic currents, partly explained by the changes in pH that it generates. However, these effects have not yet been demonstrated. The aim of this study was to evaluate the bactericidal effect and the changes in pH caused by PNE. S. aureus were prepared in two different solutions (TSB and saline solution) and in different concentrations (from 9 to 6 Log10 CFU/mL). Bacteria were treated with three experimental PNE doses to assess bacterial death levels and the changes caused to the pH of the medium. The viable cell count showed that all experimental PNE doses had a bactericidal effect against a high concentration (9 Log10 CFU/mL) of S. aureus in saline solution (p < 0.001). Furthermore, we found that when the concentration of bacteria decreased, a lower dose of galvanic current generated the same effect as a higher dose. Changes in pH were registered only in experiments performed with saline solution. PNE had a bactericidal effect against S. aureus and the level of this effect was mainly modulated by the solution, the bacterial concentration and the dose. Changes affecting pH were modulated by the type of solution and there was no relationship between this and bacterial death.
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