RESUMO
Highly active antiretroviral therapy has dramatically reduced morbidity and mortality among patients who are HIV-positive. A retrospective review of the authors' data separated subjects into cohorts based on HIV status and matched them for age and gender. The authors' data reveal a higher fraction of venous ulcers compared with a lower fraction of pressure ulcers in the seropositive population.
Assuntos
Soropositividade para HIV/epidemiologia , Úlcera por Pressão/epidemiologia , Úlcera Varicosa/epidemiologia , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Registros Eletrônicos de Saúde , Feminino , Humanos , Incidência , Masculino , Complicações Pós-Operatórias/epidemiologia , Qualidade de Vida , Estudos Retrospectivos , Fatores de RiscoRESUMO
Hydroxyurea (HU) has been shown to induce a variety of cutaneous adverse reactions, including severe leg ulcers. This report shows a successful treatment of a HU-induced chronic wound associated with squamous cell carcinomas (SCC). A 62-year-old patient affected with polycythemia vera and treated with HU for 10 years, presented with a non healing ulcer on a left heel. The patient gave a history of suffering from the wound for over 2 years. Biopsy showed evidence of invasive SCC. The patient underwent Mohs surgery and a greater saphenous vein ablation for polycythemia vera-associated vascular complications. The wound consistently decreased in size following successive debridements and coverage with human skin equivalent. The wound healed completely after a 6-month period. A multidisciplinary team approach to the treatment proved to be effective resulting in healing of this multifactorial chronic ulcer.
Assuntos
Carcinoma de Células Escamosas/complicações , Hidroxiureia/efeitos adversos , Úlcera da Perna/induzido quimicamente , Neoplasias Cutâneas/complicações , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Doença Crônica , Desbridamento , Feminino , Humanos , Hidroxiureia/uso terapêutico , Úlcera da Perna/complicações , Úlcera da Perna/patologia , Pessoa de Meia-Idade , Cirurgia de Mohs , Policitemia Vera/complicações , Policitemia Vera/tratamento farmacológico , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Transplante de Pele , CicatrizaçãoRESUMO
Despite initial evidence suggesting a relatively benign safety profile, several subsequent case reports have detailed nephrotoxicity in patients using tenofovir disoproxil fumarate for the treatment of HIV. We report a case of rapid renal failure that developed into an HIV-naïve patient initiated on an antiretroviral regimen that included tenofovir.