Topical application of an opiate cream or gel can significantly reduce pain in a cutaneous ulcer.
Criteria:
(1) The patient has a cutaneous ulceration.
(2) The lesion is associated with significant pain.
(3) Either systemic pain therapy provides insufficient relief or has undesirable side effects.
(4) The ulcer is not amenable to other therapy.
Most patients have terminal cancer with a cutaneous lesion.
Some systemic absorption may occur but this would be less than with oral or parenteral administration.
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Specialty: Pharmacology, clinical