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Cryotherapy for neurovascular heloma?

Discussion in 'General Issues and Discussion Forum' started by Sarah B, Mar 4, 2009.

  1. Sarah B

    Sarah B Active Member


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    Hi All

    I had a colleague contact me today to ask for advice for a patient she has seen who presents with longstanding neurovascular helomata on both feet. The patient has previously been seen by a different practitioner, who had been treating the lesions weeekly using cryo.

    I haven't come across cryo as a method for treating hyperkeratoses of this type (only really for VP), and am wondering whether there is in fact any evidence for its use?

    I intend to do a literature search, but am rather pressed for time for the next couple of days - so I thought I'd ask my colleagues around the world and see what response I get!

    Many thanks for your help

    Sarah
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. Cameron

    Cameron Well-Known Member

    Sarah B

    I would think the technique is rather painful and more suited to viral infections because the infected segment of the wart lies in the epidermis. The ice ball creates a dermal epidermal blister which allows safe separation without dermal involvement. With no virus present then the wart no longer exists.

    Some pods have used electro surgical techniques on vascular corns which maybe easier to apply to small sections of the skin. Initially the lesion appears to core out cleanly caused by the dermal epidermal blister but reoccurance is high.

    Under these circumstances removing the corn (by whatever means) is only temporary. The metabolic rate of the replacement keratin is determined by whatever bio-chemical agent has been activated through the initial damage phase to the skin and if the overlying skin pathomechanics prevail (corkscrew reaction) then the new lesion will re-present like the old one.

    toeslayer
     
  4. Sarah B

    Sarah B Active Member

    Thanks. :drinks

    I know it may seem like a bit of a daft question, but I just wanted to be sure that my reaction was appropriate!

    I would always look to resolve the lesion(s) by altering the stresses on the skin as far as possible in order to achieve a longer-term outcome.

    S
     
  5. Graham

    Graham RIP

    Don't do it! It doesn't help.

    Electro hyfrecation or radio excission works verywell, under local infiltaration and/or ankle block.

    Just my experience
     
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