Intervention
renal toxicity, necrotic, sclerosing, pain
ULCERATED, NECROTIC, COMPLICATIONS
Before starting treatment (preoperatively), we obtained a complete medical and dental history from all the patients in both groups to figure out the size, texture, consistency, pain, location and duration of the lesion. We then performed phase I therapy and instructed patients to maintain oral hygiene measures [Small incisional biopsy samples 2 × 2 mm were taken under local anaesthesia from the most ulcerated area and sent for histological analysis to confirm the diagnosis of the clinical picture. The tissue samples were fixed in 10% neutral formalin and embedded in paraffin. Five-micrometre sections were obtained and submitted for routine hematoxylin and eosin staining [After histopathological confirmation of PG, we divided the twenty patients into two groups as follows:Laser-treated group (test): This group was made up of ten patients treated using diode lasers (Medency Primo, Piazza della Libertà, 49, 36,077 Altavilla Vicentina VI, Italy). The surgical area was anaesthetised using a local anaesthetic agent (Alexandricaine 1/100,000, Alexandria Co. for Pharmaceuticals & Chemical Industries, Awayed Alexandria, Egypt). Diode lasers (with a wavelength of 980 nm) were operated in the continuous wave mode with an output power of 3 W in the contact mode. The tip was moved around the base of the lesion in circles. The base of the lesion was cut precisely till the whole mass was entirely excised [Clinical photographs showing a laser-treated case. Sclerotherapy-treated (control) group: This group was made up of ten patients who were treated with injections of a sclerosing agent (Ethanolamine oleate® 5% Amp, EPICO, Egypt). After anaesthetising the surgical site with a local anaesthetic agent, the lesion was injected with the sclerosing agent, 5% EO, diluted in distilled water (Otsuka water for injection (5 ml), Egypt Otsuka Pharmaceutical Co. S.A.E, Egypt) to yield a 2.5% concentration that is used to prevent systemic complications such as renal toxicity. According to their respective sizes, 1.5–3 ml of the solution was injected slowly into the lesion using a 23-gauge needle until it leaked out from the surface. Then, the lesion was compressed for five minutes and observed daily for a week after injection until it became necrotic and fell off spontaneously. (Fig. Clinical photographs showing a sclerotherapy-treated case. Postoperatively, patients from both groups were prescribed a twice-daily nonsteroidal anti-inflammatory drug, Diclofenac Potassium (Catafast