UNASSIGNED: Fifty-one patients diagnosed with severe IGM were included in the study and treated with either local steroid injection (LSI) alone (n = 25) or combined LSI with systemic oral steroid treatment (OST) (n = 26). The local steroid injection protocol included an intralesional triamcinolone acetonide injection into the palpable granulomas every 4-week, and topical administration of steroid-containing pomades twice a day on the affected surface of the breast. Patients with a combined LSI and OST received low-dose oral methylprednisolone (<16 mg).
UNASSIGNED: Patients with LSI alone required more LSI applications than those in the combined LSI with OST group (LSI: 5 ± 2.9; vs. LSI/OST: 3.5 ± 2.5; p = 0.080) to obtain an effective optimum therapeutic response. At a median of 12 months (range, 4-42), no difference was found in complete response rates between patients in the LSI group and the combined LSI group with OST (52 vs. 53.9%, p = 0.999). However, steroid-related systemic side effects were lower in the LSI alone group (p < 0.008).
UNASSIGNED: Local steroid injection could be considered as the first-line treatment in patients with severe IGM until a therapeutic response has been obtained either as the sole treatment modality or combined with oral steroids. Compared with systemic oral steroid therapy, local steroid administration can be considered a new treatment modality with fewer side effects.
■51例被诊断为严重IGM的患者被纳入研究,并单独使用局部类固醇注射(LSI)(n=25)或LSI联合全身口服类固醇治疗(OST)(n=26)。局部类固醇注射方案包括每4周将曲安奈德病灶内注射到可触知的肉芽肿中,并在受影响的乳房表面上每天两次局部施用含类固醇的润发。联合使用LSI和OST的患者接受低剂量口服甲基强的松龙(<16mg)。
■单独使用LSI的患者比使用LSI和OST的患者需要更多的LSI应用(LSI:5±2.9;与LSI/OST:3.5±2.5;p=0.080)以获得有效的最佳治疗反应。中位数为12个月(范围,4-42),LSI组和合并有OST的LSI组患者的完全缓解率无差异(52vs.53.9%,p=0.999)。然而,单纯LSI组类固醇相关的全身副作用较低(p<0.008).
■对于患有严重IGM的患者,局部注射类固醇可被视为一线治疗,直到作为唯一的治疗方式或与口服类固醇联合获得治疗反应。与全身口服类固醇治疗相比,局部使用类固醇可被认为是一种副作用较少的新治疗方式.