A Case Report on Treatment of Nonhealing Leg Ulcer: Do Not Forget the Underlying Disease.
Int J Low Extrem Wounds
; 22(1): 190-193, 2023 Mar.
Article
em En
| MEDLINE
| ID: mdl-33745332
ABSTRACT
Prevalence of nonhealing ulcers of lower extremities has increased over years causing heavy health, social, and economic burdens. Chronic ulcers are difficult to treat since they require tailored multistep treatment and patient compliance. To treat chronic wounds successfully, clinicians must keep in mind the ulcer etiology as well as the underlying diseases. Several factors may be involved in the pathogenesis of chronic skin ulcers. Leukocytoclastic vasculitis belongs to the group of immune vascular diseases and may be an extrahepatic manifestation of hepatitis C virus (HCV) infection. We describe the case of a patient with a nonhealing vasculitic leg ulcer and chronic HCV infection successfully treated with the combination of advanced dermal substitute and direct-acting antiviral therapy. An 81-year-old female presented to our unit with a 6-month history of a leg ulcer that developed from an exudating skin nodule. At presentation, the lesion was large,caused a severe pain and was unresponsive to analgesics. Skin biopsy showed leukocytoclastic vasculitis. She had a history of old untreated HCV infection, hypertension, type 2 diabetes mellitus, chronic venous insufficiency and tibial arteriopathy. The application of porcine-derived dermal substitute achieved only initial improvement. Therefore, direct-acting antiviral therapy was started, and when HCV RNA became undetectable in blood, pain disappeared and skin ulcer improved up to healing. In conclusion vasculitic leg ulcers can be caused by HCV infection. In such cases, even the use of innovative skin therapy, may obtain only initial and partial improvement, and eradication of HCV viremiais essential to obtain wound healing.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Úlcera Varicosa
/
Vasculite
/
Hepatite C Crônica
/
Diabetes Mellitus Tipo 2
/
Úlcera da Perna
Tipo de estudo:
Risk_factors_studies
Limite:
Animals
Idioma:
En
Revista:
Int J Low Extrem Wounds
Assunto da revista:
TRAUMATOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Itália