The Global Diabetes Community Forum
A number of treatments are effective..
• Intralesional steroid injection is almost always effective for local disease but less effective and less practical in generalised disease, and more steroid is needed.
• Potent steroid creams may be enhanced by using under occlusion.
• Cryotherapy works but may cause hypopigmentation or hyperpigmentation. Some regard it as the treatment of choice.2
• Generalised disease is not so amenable to the steroid treatment and is also less likely to resolve spontaneously. Systemic treatments have been disappointing. There are many options, none of which is satisfactory. They include psoralen + UVA (PUVA) treatment, oral steroids, dapsone, chlorambucil and ciclosporin. Trials have usually been small. The tumour necrosis factor inhibitor infliximab may be useful in recalcitrant cases.
• With subcutaneous lesions in children, the best management is reassurance.
• Treatment of perforating lesions is disappointing.
Registered users: AdamF, biggurs, Bing [Bot], brakes, Brandon1*, DanielBail, dawnpad, Engineer88, Google [Bot], Google Adsense [Bot], Google Feedfetcher, Jokeeble1987, lacey1, Madbazoo, Majestic-12 [Bot], Mr Happy, notafanofsugar, Toriana, wobbles