Trichloroacetic acid 80% (800mg/1ml) solution

Xanthelasma palpebrarum is a common benign eyelid lesion with multiple treatment options. Objectives: To compare the efficacy and safety of 100% trichloroacetic acid (TCA) versus cryotherapy in its management. Methods: A randomized controlled trial was conducted at the Department of Dermatology, Nishtar Hospital, Multan, from November 2024 to April 2025. Sixty patients with untreated bilateral xanthelasma palpebrarum were enrolled using non-probability consecutive sampling and randomly assigned using a computer-generated simple randomization technique (1:1) to receive either 100% trichloroacetic acid or cryotherapy. Treatment efficacy and adverse effects were evaluated at six weeks using standardized clinical criteria. Data were analyzed using SPSS version 26. A confidence level of 95% was used for all statistical analyses. Results were considered statistically significant at a p-value≤0.05. Results: A total of 60 patients (30 patients in each group) with xanthelasma palpebrarum were enrolled, with a mean age of 40.10 ± 7.40 years and a mean disease duration of 11.18 ± 2.94 months. Females comprised 60.0% of the sample, and 63.3% were aged 36–55 years. Excellent treatment response was observed in 53.3% of patients treated with 100% TCA and 20.0% with cryotherapy (p=0.023). Hyperpigmentation (p=0.020) and scarring (p=0.010) were significantly higher in the TCA group. Age, gender, and lesion location showed no significant association with efficacy or adverse effects. Conclusions: TCA offers superior clinical efficacy compared to cryotherapy but with a higher risk of adverse cosmetic effects, underscoring the need for individualized treatment planning in xanthelasma management.

Abstract licence: CC BY 4.0

Abstract Background The tympanic membrane (TM) forms the partition between the external auditory canal and the middle ear. Perforations occur as a result of acute otitis media or traumatic causes which undergoes healing spontaneously over 3 to 4 weeks. Non-surgical methods are successful in the closure of small to medium-sized perforations. Chemicals used for the cauterization of the margins of perforation are trichloroacetic acid and silver nitrate. This study was performed in a total of 90 patients. External auditory canal, tympanic membrane, site and size of perforation, and middle ear mucosa status were assessed followed by pure tone audiometry. One group constituting 45 subjects underwent TCA cauterization under sterile precautions. Another group of 45 subjects underwent the same procedure with TCA cautery and gel foam application for perforation closure. The procedure was repeated once a week for about 6 weeks. The effectiveness of these two procedures was compared between the two groups after a waiting period of 2 weeks. Results The mean age of the study population is 41.84 ± 16.71. Of the 90 study participants, 54.4% (N = 49) were less than 40 years of age, gender, cause, and laterality of perforation were not associated with the outcome whereas the size of the perforation was significantly associated with the closure of TM perforation with chi-square value of 7.028 and P value of 0.008 (< 0.05). Overall, TM closure was achieved in 3.56 applications in TCA with gel foam patching whereas in 6.02 applications with TCA alone. Conclusion TCA cauterization with or without gel foam patching can be performed as a first-line treatment in adults with small to medium-sized perforations.

Abstract licence: CC BY 4.0