Cutaneous warts are a common pediatric complaint with modest response to first‐line treatments. Warts are a manifestation of human papillomavirus (HPV) infection and are cleared by cell‐mediated immunity (CMI). Intralesional immunotherapy treatments have been studied as alternative therapies, particularly for recalcitrant or multiple warts, including Candida antigen, mumps antigen, the combined measles, mumps, and rubella (MMR) vaccine, tuberculin purified protein derivative (PPD), and bacille Calmette‐Guerin (BCG) vaccine. These treatments are thought to increase HPV recognition by stimulating CMI. In this review, we evaluate and compare the efficacy and adverse effects of intralesional immunotherapy in the treatment of pediatric warts. Articles met inclusion criteria if they specifically evaluated the effects of intralesional immunotherapy (candida, MMR, tuberculin PPD, or BCG) as treatment for cutaneous warts in a pediatric population, and if they quantified treatment effect in a reproducible manner. Twenty‐one studies met criteria. Many studies demonstrated complete clearance of injected common warts in pediatric patients with clearance rates ranging from 23.3% to 95.2%. Distant wart resolution was common. Intralesional immunotherapy is a promising treatment option for cutaneous warts in children.
Androgenetic alopecia (AGA) is common and associated with significant psychosocial distress. Treatment options are needed for patients that do not adequately respond to first line treatments of finasteride or minoxidil. Topical ketoconazole has been proposed as a promising treatment. The goal of this systematic review
Intraosseous needle access is a reliable method of vascular access used for rapid fluid resuscitation and delivery of medications in certain emergent settings. Fluid extravasation is a possible complication of intraosseous needle access that can lead to compartment syndrome. To our knowledge, imaging findings resulting from this complication have not been described. In this case report, we demonstrate conventional radiograph, computed tomography, and magnetic resonance image findings due to extravasation of resuscitation fluids following the aberrant insertion of an intraosseous needle in an unstable adult trauma patient. We also describe a new radiographic sign associated with this iatrogenic complication, the “Nicked-Cortex” sign.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.