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Liquid nitrogen cryotherapy for seborrheic keratosis: a report of 131 cases

Time: 2020-09-15 10:08 Source: unknown Author: Bander liquid nitrogen tank Click: second
Seborrheic keratosis was usually treated with 5% 5-FU, 0.1% retinoic acid cold cream, 10% urea ointment, and electric burning and laser treatment. The curative effect of topical medicine is not good, electric cauterization and laser treatment have burns, and should not be used for multiple patients. 131 cases of seborrheic keratosis were treated with liquid nitrogen cryotherapy. liquid nitrogen tank

1. Clinical data
There were 131 cases, 119 males and 12 females. The average age was 59.76 years (range, 32-77 years). The course of disease ranged from 1 month to 40 years, with an average of 5.46 years. There were 18 heads in 5 cases. There were 819 facial lesions in 96 cases. Neck in 2 cases, 3 cases. There were 48 trunk cadres in 15 cases. There were 25 upper limbs in 3 cases. There were 14 dorsum of hands in 3 cases. There were 7 cases, 17 lesions, 131 cases, 944 lesions.

Methods and results
131 cases were treated with cotton swab contact and spray. Before freezing, 75% alcohol was used to disinfect the local area, and 75% alcohol was applied to the affected area after freezing. The large frozen area or friction part was wrapped with alcohol gauze.
Methods: 1
(1) contact method: 116 cases, 922 lesions. The lesion was frozen and thawed 3-5 times with a cotton swab dipped in liquid nitrogen for 3-5 seconds until local swelling. This method is usually used for small lesions.
(2) spray method: 15 cases, 22 lesions. The liquid nitrogen was directly sprayed to the surface of the lesion in the form of mist from the storage liquid mouth through the capillary infusion tube, freezing and thawing for 3-5 seconds each time. This method is usually used for patchy skin lesions.
(3) freezing and thawing times: after the tissue is frozen and thawed naturally, it is called one freeze-thaw. Repeated treatment once is twice ice melting. According to the general condition, the lesions were thawed for 5 times. (4) Freezing interval: most cases can be cured by one freezing, and a few cases can be cured by two times of freezing. The interval between the two cryotherapy was usually 4 weeks after the local wound scab naturally fell off after the last cryotherapy. It usually takes 1-2 weeks for scab to fall off. In 131 cases, the scab removal days were 26 days long and 2 days short, with an average of 13.49 days.
2
(1) criteria of curative effect: Cure: the lesion completely disappeared. Improvement: 90% of the lesions disappeared. Invalid: no change after freezing for 1 time.
(2) results: in 131 cases, 130 cases were cured and 941 lesions were cured by one-time freezing. One case was cured twice and three lesions were found. The cure rate was 100%. After freezing, 22 cases (16.79%) had pigmentation and 5 cases (3.82%) had hypopigmentation. All of them recovered to normal skin color about half a year after operation. Follow up for 2 years showed no recurrence.
(3) freezing reaction: red, swelling, pain and blister accompanied by freezing are all frozen.
Normal reaction:
Redness and swelling: due to the superficial seborrheic keratosis and short freezing time, the redness and swelling reaction is mild after freezing. In most cases, the redness and swelling can disappear on the day of treatment, and in some cases, the redness and swelling can subside after 1 week of treatment. liquid nitrogen tank
Blisters: 131 cases of frozen, 15 cases of obvious blisters, accounting for 11.45% of the total. The blister is slightly higher than the skin, the blister wall is very thin, generally absorbed in 3-7 days.
Pain: there is slight acupuncture pain in local area during liquid nitrogen freezing. With the decrease of temperature, the pain decreases or disappears. When the freezing ends, the tissue melts naturally. After rewarming, there is slight burning pain in the local area. The time of pain disappearance varies according to the individual and location. Generally, it disappears in a few minutes. Although patients disappear in 2 days after treatment.
According to our observation, it takes about half a year to recover to normal skin color.

Discussion
The curative effect of liquid nitrogen cryotherapy on seborrheic keratosis is high, the side effect is small, and it is easy to operate. There were 944 lesions in 131 cases. Among them, 130 cases were cured once and 941 lesions were found.
The histopathological change of seborrheic keratosis is basal cell papilloma. Above the normal skin level, the boundary is very clear, especially like a stamp, so it is suitable for cryotherapy with liquid nitrogen. After frozen tissue necrosis and shedding, so as to receive a good effect, no scar, the change of pigment is temporary, reversible.
Seborrheic keratosis (seborrheic keratosis) is a common skin disease in the elderly, which often occurs on the face and affects the facial trimming and aesthetics. There are also some patients with fear of cancer, mental stress. This therapy can relieve some patients' fear of cancer and get better cosmetic effect.
The redness, swelling, pain, blister, scab, desquamation and pigment changes after freezing were normal reactions. General tissue loose parts easy to edema, blisters, upper and lower eyelids easy to edema, edema subsided for a long time, individual patients in postoperative 1 week subsided. The older the age, the longer the scab removal days and the longer the lower limb scab removal time. In addition, it is related to the depth of freezing.
There were individual differences in pigment changes, which were related to the sun exposure. Usually avoid the sun after freezing. In this group, one side of the face which was not exposed to sunlight was treated with cryotherapy. liquid nitrogen tank

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