1/30. Ulcerated disseminated cutaneous leishmaniasis associated with vitiligo, hypothyroidism, and diabetes mellitus in a patient with down syndrome.We report a 35-year-old man who was referred to our dermatology department with multiple, nodular, ulcerated, and crusted lesions disseminated on the face, trunk, and extremities. He has a known diagnosis of down syndrome. The past medical history also included vitiligo (for 20 years), hypothyroidism (for 2 years), and type-II diabetes mellitus (for 3 months). Direct smear of an ulcer was positive for leishmania. skin biopsy confirmed the diagnosis. A leishmanin skin test was negative. polymerase chain reaction (PCR) from two separate skin biopsies demonstrated the presence of leishmania major. To our knowledge, this is the first report of disseminated cutaneous leishmaniasis (DCL) caused by L. major in iran, and also the first report of association between DCL with down syndrome, vitiligo, hypothyroidism, and diabetes mellitus.- - - - - - - - - - ranking = 1keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
2/30. Blisters, ulceration and autonomic neuropathy in carpal tunnel syndrome.We describe three patients with trophic ulceration and blistering of the fingertips associated with carpal tunnel syndrome. One of the patients also had non-insulin-dependent diabetes mellitus. Autonomic neuropathy distal to the carpal tunnel was probably present in all subjects at the time of presentation; in the patient with recent symptoms the skin was warm, and sweating was virtually absent, whilst the other two patients described cold skin, consistent with prolonged autonomic neuropathy.- - - - - - - - - - ranking = 0.16666666666667keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
3/30. Diverse applications of negative pressure wound therapy: a multiple case report.The purpose of this retrospective case report was to describe the results of negative pressure wound therapy (NP WT) in the treatment of wounds of various size, location and etiology in four patients. The effects of NP WT were assessed in the following patients. 1) A 68-year-old male diagnosed with cellulitis presenting with two open wounds on the left foot; 2) a 60-year-old male diagnosed with Type II diabetes mellitus presenting with a full thickness wound on the plantar surface of the right foot; 3) a 64-year-old male diagnosed with necrotizing fasciitis, diabetes mellitus, and Crohn's disease presenting with a left gluteal wound; and 4) a 47-year-old obese female diagnosed with necrotizing fasciitis presenting with a wound of the right groin and buttock. All wounds were debrided of devitalized tissue and contained nearly 100% granulation tissue prior to NPWT treatment. NPWT was applied three times per week, each application lasting 48 hrs, followed by dressing change, cleaning of the wound bed and continued debridement as required. Treatment duration, varying from 4-9 weeks, corresponded to the patient's length of stay at the sub-acute rehabilitation facility, and pressure settings ranged from 100 to 200 mmHg. Measurements of wound length, width, depth and appearance were recorded once a week. Follow-up was conducted 6-18 months post treatment to assess self-reported wound status. NPWT resulted in reductions of wound length, width, and depth, with the greatest reduction in each case being wound depth. Reduction in wound depth ranged from 75-100% (100% being complete wound closure), with four of the five wounds exceeding 90%. Reduction in wound length ranged from 32-100%, with three wounds exceeding 80%, and reduction in wound width ranged from 35-100%, with three wounds exceeding 80%. Three wounds closed completely either during therapy or soon (2-4 weeks) thereafter, and two wounds were reduced in size sufficiently for treatment via skin grafts. NPWT, applied to wounds of diverse size, location, and etiology, resulted in reductions in wound length, width, and depth in four patient cases, with the greatest influence of reducing wound depth.- - - - - - - - - - ranking = 0.33333333333333keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
4/30. Successful management of critical limb ischemia with intravenous sodium thiosulfate in a chronic hemodialysis patient.vascular calcification is common among hemodialysis (HD) patients and contributes to the development of peripheral arterial disease. A 57-year-old Japanese man who had been on HD for 30 years was referred to us for severe pain with multiple ulcers on his toes and fingers. He was an ex-smoker and had no diabetes mellitus. On admission, he had ulcers on his big toes bilaterally and right 2nd - 4th fingers. Peripheral pulses were strong and his ankle-brachial pressure index was above 1.3. Laboratory data were as follows: calcium 9.9 mg/dl, albumin 3.3 g/dl, phosphate 3.0 mg/dl, Ca x P product 30, and parathyroid hormone 98 pg/ml. He had a parathyroidectomy in 1998 and 1999. x-rays of his hands and legs showed diffuse subcutaneous arteriolar calcification. angiography revealed no local stenotic lesions. Despite intensive therapies including hyperbaric oxygen therapy, painful gangrene developed on his right big toe and the pain was so intense that he could not go to sleep in a supine position. We infused intravenous sodium thiosulfate (20 g) 3 times weekly, based on previous reports. Within 4 - 5 days, he experienced rapid and dramatic symptom relief. The score of the visual analogue pain scale improved from 10/10 - 2/10. The signs of ischemia, measured by transcutaneous partial oxygen pressure and thermography, improved significantly. During the infusion of sodium thiosulfate, the patient complained of nausea, vomiting and hyperosmia. These adverse symptoms were resolved after discontinuation of the infusion. pain relief was sustained and he could walk after 2 weeks of infusion. Our case supports the use of sodium thiosulfate as a novel therapeutic choice for critical limb ischemia with severe vascular calcification in chronic HD patients.- - - - - - - - - - ranking = 0.16666666666667keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
5/30. pyoderma gangrenosum with large circumferential perianal skin loss in a child.pyoderma gangrenosum is an uncommon skin disorder characterised by deep ulcers surrounded by a violaceous over-hanging edge. Although in many instances there is no clear association with any underlying disease, pyoderma gangrenosum has been described in ulcerative colitis, Crohn's disease, polyarthritis, diabetes mellitus and myeloma. pyoderma gangrenosum may also be seen as a rare manifestation of myeloproliferative disease including leukaemia. In children, as in our case, it may be the presenting feature.- - - - - - - - - - ranking = 0.16666666666667keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
6/30. Stimulation of healing of chronic wounds by epidermal growth factor.We evaluated the effect of topical epidermal growth factor treatment on healing of chronic wounds in a prospective, open-label, crossover trial. Five males and four females who ranged in age from 40 to 72 years (average 57 /- 9 years) were enrolled. Four patients had adult-onset diabetes mellitus, two had rheumatoid arthritis, two had old burn scars, and one had a failed abdominal incision. The average duration of the ulcers prior to treatment with epidermal growth factor was 12 /- 5 months (range 1 to 48 months). Following failure of the wounds to heal with conventional therapies, including debridement, skin graphs, and vascular reconstruction, wounds were treated twice daily with Silvadene alone for periods ranging from 3 weeks to 6 months. No evidence of healing was observed in any of the patients' wounds during Silvadene treatment, and patients were crossed over to twice a day treatment with Silvadene containing 10 micrograms epidermal growth factor per gram. Wounds of eight patients healed completely with epidermal growth factor-Silvadene treatment in an average of 34 /- 26 days (mean /- SD, range 12 to 92 days) and did not reoccur for periods ranging from 1 to 4 years. One patient failed therapy. These results suggest that topical treatment of chronic wounds with epidermal growth factor may stimulate healing.- - - - - - - - - - ranking = 0.16666666666667keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
7/30. methods of treating plantar ulcers.The purpose of this article is to describe the indications, precautions, and fabrication techniques for orthotic devices the authors use to facilitate the healing of plantar ulcers. The methods of fabricating and applying three types of orthotic devices developed by the staff at the Gillis W Long Hansen's Disease Center--walking casts, walking splints, and cutout sandals--are described. Patient examples are given for each of the methods. These techniques, in conjunction with patient education and the use of special footwear, provide clinicians with procedures they can use to aid in the healing of plantar ulcers secondary to leprosy, diabetes, or other neuropathic conditions.- - - - - - - - - - ranking = 0.032415139395854keywords = diabetes (Clic here for more details about this article) |
8/30. gastroparesis: a possible complication in diabetic patients.A case is presented of gastroparesis as a complication of diabetes mellitus in a 31-year-old insulin-dependent diabetic patient. The patient was admitted to the hospital for cellulitis of the right foot with ulceration of the hallux, as well as ulceration of the fifth toe of the left foot. This paper will deal with a case report and review of the literature as it pertains to gastroparesis as a complication of diabetes mellitus.- - - - - - - - - - ranking = 0.33333333333333keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
9/30. Diabetic ulcer healing preparations from the skin of the Arabian Gulf catfish (Arius bilineatus Val.): a novel and effective treatment.A novel and simple treatment for healing of infected diabetic foot ulcers in uncontrolled diabetes mellitus patients was devised. The preparations which involve aqueous extracts from the skin of the Arabian Gulf catfish are enriched with different fractions from the same source and with catfish lipids. Eight patients with non-healing foot ulcers and two with wet gangrene were treated. It was found that the ulcers were completely healed. The gangrenic feet noticeably improved in 48 h. The treatment resulted in natural debridation of the necrotic tissues. The ulcer site was invaded by angiogenesis and granulation tissues. sensation returned to the otherwise neuropathic extremity. The rate of growth of new tissues was proportional to the amount of healing material applied, and its effect ceased shortly after the interruption of the treatment. No. atrophy of the skin lesions was noted and no side-effects were detected.- - - - - - - - - - ranking = 0.16666666666667keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
10/30. The neuropathic foot--a management scheme: a case report.The purpose of this case report is to present a management approach that was effective in the healing and long-term care of a neuropathic plantar ulcer in a patient with diabetes mellitus. The report demonstrates that a successful management program must go beyond the stage of healing and include patient education and techniques for reducing plantar pressures to prevent the recurrence of plantar ulcers.- - - - - - - - - - ranking = 0.16666666666667keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
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