The most common side effect reported with Transdermal Verapamil 15% Gel, affecting 3-5% of Peyronie's disease patients, is varying degrees of skin irritation. Some patients using the medication for the first time may experience mild itching/irritation during the first few days of treatment. This is normal and usually resolves within 3-4 days. Other patients may experience more severe contact dermatitis, including itching, burning, redness, or swelling. More persistent or severe irritation can usually be treated with topical corticosteroids. Based on the individual symptoms, PDLabs will work with the patient and prescribing physician to determine the best course of treatment to resolve irritation.
1. Do nothing: the nodules are annoying but usually self-limiting. They do not grow indefinitely, so if you can put them down as life's minor annoyance, most patients choose to just leave them alone.
2. Conservative or Non-invasive: Vigorous stretching, accommodative orthotics, physical therapy, and topical transderamal Verapamil.
3. Surgery: injections with a corticosteroid can be helpful to decrease the inflammation around the nodule, but if they are large and painful; most go on to surgical excision.
What should you do? A personal question, that only you with the help of your doctor can answer. In my opinion, if the nodule is small, leave it alone. If it is increasing in size, then it should be addressed. If the nodule is of moderate size, with no intrasubstance calcifications on x-ray, and is annoying; a three to six month trial of transdermal verapamil coupled with an accommodative orthotic and physical therapy can be helpful. If it meets these criteria and is a little soft, then a steroid injection may also help decrease the size. If the lesion is large, painful, or has intrasubstance calcifications on x-ray; then excision is most likely your best option. Simple excision is not enough with these lesions, removal of not only the lesion, but a large margin is necessary to decrease recurrence rates.
If you have a painful lump in your arch, seek the advice of your podiatrist. Help is only a phone call or mouse-click away!
While contraction is usually observed at the hand (Dupuytren's contraction), it is not typical for Ledderhose disease though it might happen. Development of cords seems to be less dominant for Ledderhose. Possibly weight and continuous exercise keep feet and toes straight or the Ledderhose nodules reside in a more static area and are thus subject to less pulling forces than the nodule's in the hand. Thus therapies to straighten toes again are less important for Ledderhose disease, the focus is more on reducing the size of the nodules, reducing pain and inflammation, and maintaining the ability to walk. Therefore therapies for Ledderhose and Dupuytren's are probably as similar as foot and hand: similar, but not the same.