Case Report
Improvement of Chronic Morning Hand Stiffness and Pain with Stellate Ganglion Block in a Seronegative Patient: A Case Report
Issue:
Volume 3, Issue 3, September 2024
Pages:
22-25
Received:
14 November 2024
Accepted:
28 November 2024
Published:
7 December 2024
Abstract: Chronic hand pain poses a clinical challenge, especially when standard diagnostic tests return negative results. This case report details a 45-year-old woman who experienced persistent stiffness and pain in both hands for 20 years, which was effectively treated with a stellate ganglion block (SGB). The patient, employed in an office setting that required extensive computer use, noticed her symptoms worsened during busy work periods. Despite negative blood tests for rheumatoid factor, anticyclic citrullinated peptide antibody, and other inflammatory markers, she endured prolonged morning stiffness and pain. Previous treatments, including nonsteroidal anti-inflammatory drugs, were either ineffective or poorly tolerated. After receiving three weekly SGB treatments, the patient reported significant relief from pain and stiffness, with her Numerical Rating Scale score dropping from 7 to 2 and stiffness decreasing by about 50%. Similar improvements were noted with left-sided SGB treatments. At a three-month follow-up, the patient remained mostly symptom-free, experiencing a notable enhancement in her quality of life and work performance. This case indicates that SGB may serve as an effective alternative for treating seronegative chronic hand pain syndromes, particularly in patients unresponsive to traditional therapies. The mechanism behind SGB's effectiveness is complex, involving the modulation of sympathetic nervous system activity, inhibition of pain signal transmission, and promotion of vasodilation. While this case showed remarkable treatment outcomes, similar results may not be guaranteed for all patients. More research is necessary to determine the long-term efficacy and safety of SGB for similar patient populations and to assess its potential cost-effectiveness in managing chronic pain conditions.
Abstract: Chronic hand pain poses a clinical challenge, especially when standard diagnostic tests return negative results. This case report details a 45-year-old woman who experienced persistent stiffness and pain in both hands for 20 years, which was effectively treated with a stellate ganglion block (SGB). The patient, employed in an office setting that re...
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Case Report
A Case of Chronic Pityriasis Lichenoides Treated with Fire Needle Combined with Narrow-Band Ultraviolet B (NB-UVB) Irradiation
Lu Changchun
,
Shi Jianping*
Issue:
Volume 3, Issue 3, September 2024
Pages:
26-29
Received:
25 November 2024
Accepted:
10 December 2024
Published:
25 December 2024
DOI:
10.11648/j.ijmcr.20240303.12
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Abstract: This report presents a case treated with fire needle therapy combined with narrow-band ultraviolet B (NB-UVB) for chronic pityriasis lichenoides. The patient was a 44-year-old female who exhibited recurrent erythema, scaling, and pruritus on the limbs and trunk for a duration of five months. Dermatological examination revealed patchy bright red rashes on the chest with indistinct borders and no significant desquamation; scattered papules ranging from rice to soybean size, pale red to reddish-brown in color, were observed on the limbs, trunk, and buttocks, some of which were covered with fine, thin scales that shed easily. Additionally, patchy erythematous papules were noted on both palms, soles, and the dorsal aspects of the toes, accompanied by scattered vesicles and papules of similar size, some exhibiting minimal exudate and others covered with crusts. Nikolsky's sign was negative, and there was no thickening or deformation of the nails or toenails, nor were there palpable superficial lymph nodes. Dermatopathological findings revealed focal incomplete keratinization, neutrophilic exudate beneath the epidermis, mild epidermal hyperplasia, intercellular edema in the spinous layer, and liquefactive degeneration of the basal cells. A small number of lymphocytes were observed migrating into the epidermis, with lymphocyte-dominated inflammatory cell infiltration surrounding the blood vessels in the superficial to middle dermis, along with visible nuclear dust. The diagnosis was confirmed as chronic pityriasis lichenoides. Following one month of treatment with fire needle therapy in conjunction with NB-UVB irradiation, there was notable improvement in almost all clinical manifestations; the lesions on the chest completely resolved, and those on the dorsal feet became dry and convergent, with ongoing follow-up.
Abstract: This report presents a case treated with fire needle therapy combined with narrow-band ultraviolet B (NB-UVB) for chronic pityriasis lichenoides. The patient was a 44-year-old female who exhibited recurrent erythema, scaling, and pruritus on the limbs and trunk for a duration of five months. Dermatological examination revealed patchy bright red ras...
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