[Leish-l] inquiry

[Satoskar, Abhay]

Yes, its true that the RF therapy needs to be administered under local anesthesia. However, most of our patients have single or 2-3 lesions which we can treat with RF therapy. Patients with more than 5 lesions are treated with SSG. In India (probably other endemic countries) our experience is that it is difficult to ensure 100% patient compliance for any treatment that involves multiple administrations or applications. In our experience CL patients are reluctant to visit clinic for completing intralesional SSG regiment because those injections are painful. We find that with RF therapy thsi is not an issue since most cases require only single treatment.  Newer lidocain creams such as EMLA could be a great option and we may try that.

Abhay R Satoskar MD, PhD
Professor
Departments of Pathology and Microbiology
129 Hamilton Hall
1645 Neil Avenue
The Ohio State University
Columbus, Ohio
Tel: 614-366-3417
________________________________________
From: Magill, Alan J COL MIL USA MEDCOM WRAIR [ALAN.MAGILL at US.ARMY.MIL]
Sent: Wednesday, June 08, 2011 3:45 PM
To: Chang, Kwang-Poo; John David
Cc: Satoskar, Abhay; vishwamohan_katoch at yahoo.co.in; Raj; leish-l at lineu.icb.usp.br
Subject: RE: [Leish-l] inquiry

John certainly knows well..

50C is not tolerable to human skin. All potential lesions to be treated need to be appropriately cleaned and anesthetized with intradermal and subQ injection of lidocaine. I have never tried the newer lidocaine creams such as EMLA, they might work as well. This can be somewhat rate limiting for multiple lesions as each lesion needs to be prepared, injected, and you need to wait about 10 plus minutes for the lidocaine to work.

Trying the Thermomed device on normal skin (try on yourself) will show that most people can only get to about 43 or 44 C before quickly removing the device from their skin.

Alan Magill


________________________________
From: leish-l-bounces at lineu.icb.usp.br [leish-l-bounces at lineu.icb.usp.br] On Behalf Of Chang, Kwang-Poo [KwangPoo.Chang at rosalindfranklin.edu]
Sent: Monday, June 06, 2011 12:02 PM
To: John David
Cc: Satoskar, Abhay; vishwamohan_katoch at yahoo.co.in; Raj; leish-l at lineu.icb.usp.br
Subject: Re: [Leish-l] inquiry

Any chance to make it available for additional trials elsewhere ?

I recall your statement in our conversation about the advantage of this instrument over the heating lamp. That is to maintain the specific elevated temperature uniformly throughout the skin lesion for a sustained period. The 50 C must be the effective temperature that has been experimentally determined. It seems to be a tolerable temperature to human skin ?  Dr. Sharma may comment on this medically as a dermatologist ?

KP

________________________________
From: John David [mailto:jdavid at hsph.harvard.edu]
Sent: Sunday, June 05, 2011 11:18 PM
To: Chang, Kwang-Poo
Cc: Sharmanl; Satoskar, Abhay; Raj; Petr Volf; leish-l at lineu.icb.usp.br; hgoto at usp.br; elfadil_abass at yahoo.com; vishwamohan_katoch at yahoo.co.in
Subject: Re: [Leish-l] inquiry

The Themomed instrument shown below can produce accurate 50 degrees C  plus or minus 0.2 degrees temperature by radio wave.
from Themorsurgery Technologies. Picture below.
Two papers of a trial in Brazil and one in Afghanistan on CL below.