title: A clinical study of pingyangmycin sclerotherapy for venous malformation: an evaluation of 281 consecutive patients.
abstract: OBJECTIVE
  In China, lidocaine together with 2 mg/mL of pingyangmycin (PYM, also known as bleomycin A5) is recommended for the treatment of venous malformations (VMs). The purpose of this study was to investigate whether lidocaine has a synergistic effect with PYM in improving the therapeutic outcomes of patients with VMs. Additionally, this study aimed to evaluate the outcomes of sclerotherapy for VMs using an intralesional injection of a low concentration of PYM (0·5 mg/mL).
  
  
  METHODS
  A total of 281 patients with VMs were treated with 0·5 or 2 mg/mL of PYM with or without lidocaine and dexamethasone (DEX). All of the patients received a direct intralesional injection at a rate of 1 mL/min, and the volume of the solution varied from 1·5 to 6·0 mL per injection.
  
  
  CONCLUSIONS
  No significant differences were observed in the clinical outcomes between the PYM and PYM + lidocaine treatment groups (P > 0·05). The clinical outcomes were similar between the groups that were treated with 0·5 and 2 mg/mL of PYM, but the swelling and pain in the patients who were treated with 0·5 mg/mL of PYM were less severe compared with the patients who were treated with 2 mg/mL of PYM. A total of 29 patients with VM lesions on the glans penis were treated with 0·5 mg/mL of PYM + 0·5% lidocaine. Of these patients, 26 were cured, whereas three experienced a marked improvement.
  
  
  CONCLUSIONS
  Lidocaine does not have a synergistic effect with PYM in improving the therapeutic outcomes of patients with VMs. Sclerotherapy with a low concentration of PYM (0·5 mg/mL) combined with lidocaine and DEX is a safe and effective therapy for small superficial VMs of critical organs, such as the lips and the glans penis.
authors.affiliation: Department of Plastic Surgery, Linyi People's Hospital, Linyi, Shandong province, China.
authors.forename: N
authors.initials: N
authors.lastname: Bai
authors.forename: Y-Z
authors.initials: YZ
authors.lastname: Chen
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Fu
authors.forename: P
authors.initials: P
authors.lastname: Wu
authors.forename: W-N
authors.initials: WN
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001761:Bleomycin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D003907:Dexamethasone / Q000008:administration & dosage; D004357:Drug Synergism; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D015911:Sclerotherapy; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000779:Anesthetics, Local; D001761:Bleomycin; C025703:bleomycetin; D003907:Dexamethasone; D008012:Lidocaine
keywords: dexamethasone; lidocaine; pingyangmycin; sclerotherapy; venous malformation