Cases reported "Skin Ulcer"

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1/50. Algosteril calcium alginate dressing for moderate/high exudate.

    Algosteril is a new alginate dressing manufactured by Les Laboratoires BROTHIER and distributed by Beiersdorf Medical. It is a natural, pure, non-woven dressing made from calcium alginate fibres. It complements other products in the Beiersdorf wound care family such as Cutinova, Cutifilm and Cutisorb. Algosteril rapidly absorbs and retains wound fluid to form an integral gellified structure, thereby maintaining an ideal moist wound healing environment. It traps and immobilizes pathogenic bacteria in the network of gellified fibres, stimulates macrophage activity and activates platelets, resulting in haemostasis and accelerated wound healing.
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keywords = macrophage
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2/50. Long-term extracorporeal photoimmunotherapy for treatment of chronic cutaneous graft-versus-host disease: observations in four patients.

    BACKGROUND: Chronic cutaneous graft-versus-host disease (GvHD) can arise as a late complication after allogeneic bone marrow transplantation. patients with extensive disease to date require intensive early and long-term immunosuppression; however, treatment is often insufficient. Since the beneficial effects of phototherapy for chronic cutaneous GvHD are well known, extracorporeal photoimmunotherapy (ECP) was also tried with some success for a few single patients with this disease. OBJECTIVE: The long-term effect of ECP was evaluated in 4 patients with therapy-resistant severe chronic cutaneous GvHD after allogeneic bone marrow transplantation. methods: Four patients were treated with monthly sessions of ECP over a period of 16-40 months. disease severity was assessed by a semiquantitative score adapted from the literature including extent of skin area involved, rigidity of the skin, involvement of joints and immunosuppressive drug consumption. RESULTS: In all patients, a favorable response was observed after 6-12 treatment cycles. One patient had a complete response, 2 patients had a partial response, and 1 patient had a minor response after treatment. In 2 patients, immunosuppressive medication started before initiating ECP could be reduced or completely withdrawn under ECP. Peripheral blood lymphocyte immunophenotyping revealed reduction of CD3 CD4 T cells in 3 patients and of elevated CD3 CD8 and CD57 CD8 T cell subsets in 2 patients. Conclusion: ECP is effective in treating severe chronic cutaneous GvHD. ECP possibly exerts its effects by reducing the number of CD8 suppressor/cytotoxic T cells, the presumptive effector cells of GvHD. ECP is well tolerated with essentially no side effects and allows reducing the dosage of immunosuppressive agents.
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ranking = 0.070329478569211
keywords = bone
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3/50. Vaginal ulcers as initial presentation of subacute myelomonocytic leukemia.

    Cutaneous disorders can allow the detection of severe systemic disease. We report the case of a woman with vaginal ulcerations. The lesions persisted despite oral antibiotics, antifungal therapy and local care. biopsy showed an inflammatory ulcerating process with discrete vasculitis. Peripheral blood count showed thrombocytopenia and monocytosis, and bone marrow smears revealed as subacute myelomonocytic leukemia. A review of the literature indicates that genital ulcerations are not known in association with subacute myelomonocytic leukemia. In our case, the persistent vaginal ulcerations were the initial symptom of the subacute myelomonocytic leukemia. copyright (R) 2000 S.Karger AG, Basel
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ranking = 0.035164739284605
keywords = bone
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4/50. Comparison of granulocyte-colony, stimulating factor and granulocyte macrophage-colony stimulating factor in the treatment of chemotherapy extravasation ulcers.

    The results of perilesional granulocyte macrophage-colony stimulating factor and granulocyte-colony stimulating factor application in a patient with chemotherapy extravasation ulcers are reported. A 64-year-old patient with recurrent ovarian carcinoma was admitted to our department in February 1999. In June 1998, six cycles of chemotherapy were applied to the patient after surgery. At the first cycle, two ulcers appeared on both lower arms related to doxorubicin extravasation despite all interventions. When the patient was admitted to in our department, we observed an ulcer on the distal part of the right lower arm with a dimension of 1.5x2 cm and another on the proximal portion of the left lower arm with a dimension of 2.5x3 cm. Of those ulcers, the bigger and deeper one on the left was treated with weekly 400 mcg granulocyte macrophage-colony stimulating factor subcutaneously for three weeks. The lesion completely disappeared in the fourth week. The other ulcer that was left for control on the right arm was treated with weekly 48 M.U. granulocyte-colony stimulating factor for four weeks. This ulcer did not reduce in size. As a result granulocyte-colony stimulating factor did not affect the healing of chemotherapy extravasation ulcers, as did granulocyte macrophage-stimulating factor.
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ranking = 7
keywords = macrophage
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5/50. Severe cutaneous ulceration following treatment with thalidomide for GVHD.

    We report two cases of severe leg ulcerations in patients being treated with thalidomide for graft-versus-host disease following bone marrow transplantation. Local wound care and debridement were attempted, but one patient required skin grafting to ensure healing. We propose that this complication may be due to the antiangiogenic properties of thalidomide and urge careful attention to skin breakdown in patients being treated with this compound.
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ranking = 0.035164739284605
keywords = bone
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6/50. Subcutaneous infection with mycobacterium fortuitum after allogeneic bone marrow transplantation.

    Reports of cases of mycobacterial infections after SCT are rare. We report a 30-year-old female with a cutaneous infection of mycobacterium fortuitum 30 months after allogeneic bone marrow transplantation for acute lymphoblastic leukemia. The patient was successfully treated with surgical debridement followed by oral minocycline and clarithromycin. Mycobacterial infections should be considered in SCT patients with undiagnosed refractory chronic cutaneous infection, and surgical debridement is useful for the diagnosis and treatment of such infections.
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ranking = 0.17582369642303
keywords = bone
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7/50. Staged cranial reconstruction after epidural abscess associated with dural substitute exposure.

    Cadaveric dura mater was widely used for a long time but has recently been associated with the transmission of Creutzfelt-Jakob disease. Expanded polytetrafluoethylene sheet has been suggested as a suitable alternative in japan. Recently epidural abscesses associated with exposure to Expanded polytetrafluoethylene have been on the increase in japan.We experienced one case of staged cranial reconstruction for chronic ulcer of the head associated with MRSA epidural abscess.Surgical Technique: the exposed expanded polytetrafluoethylene must be completely removed along with the skin. Reconstruction of dura mater should be made watertight with the application of autologous free fascia lata collected from the paralyzed thigh. Autologous free fascia lata is reconstructed with the rectus abdominis muscle so that there is no dead space remaining. Calvarial bone should be reconstructed in a separate operation as at a second stage.
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ranking = 0.035164739284605
keywords = bone
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8/50. mycobacterium ulcerans infection diagnosed by polymerase chain reaction.

    mycobacterium ulcerans infection is the third most important mycobacterial infection world-wide affecting immunocompetent individuals and causes chronic progressive skin ulcers. It has been described in many different regions world-wide. The diagnosis of M. ulcerans infection is often delayed because the diagnosis is difficult to make when new cases appear outside known endemic areas. However, molecular methods are now available to diagnose and distinguish M. ulcerans from other mycobacteria, allowing rapid diagnosis. Presented here is the case of a previously well girl from Townsville, queensland, with extensive M. ulcerans infection involving the elbow joint, triceps tendon and underlying bone. Rapid diagnosis by polymerase chain reaction confirmed M. ulcerans infection. This is the first known case of M. ulcerans infection from Townsville in over 25 years, highlighting the changing epidemiology of this disease.
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ranking = 0.035164739284605
keywords = bone
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9/50. Treatment of chronic wounds with bone marrow-derived cells.

    BACKGROUND: Recent evidence indicates that bone marrow contains stem cells with the potential for differentiation into a variety of tissues, including endothelium, liver, muscle, bone, and skin. It may thus be plausible that bone marrow-derived cells can provide progenitor and/or stem cells to wounds during healing. Our objective in this study was to establish proof of principle that bone marrow-derived cells applied to chronic wounds can lead to closure of nonhealing wounds. We applied autologous bone marrow cells to chronic wounds in 3 patients with wounds of more than 1-year duration. These patients had not previously responded to standard and advanced therapies, including bioengineered skin application and grafting with autologous skin. OBSERVATIONS: Complete closure and evidence of dermal rebuilding was observed in all patients. Findings suggesting engraftment of applied cells was observed in biopsy specimens of treated wounds. Clinical and histologic evidence of reduced scarring was also observed. CONCLUSION: Directly applied bone marrow-derived cells can lead to dermal rebuilding and closure of nonhealing chronic wounds.
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ranking = 0.35164739284605
keywords = bone
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10/50. Diffuse cutaneous leishmaniasis with atypical aspects.

    A 16-year-old man had long-standing diffuse cutaneous leishmaniasis with the following characteristics: diffuse infiltrated lesions rich in amastigotes, absence of mucosal involvement, and lack of parasite-specific cell-mediated immune response. In situ identification of leishmania mexicana amazonensis was achieved by the use of monoclonal antibodies. Clinically, as an atypical finding there was deep and extensive ulceration in the lower limbs. Histologically, an atypical characteristic was the presence of a high number of eosinophils in the infiltrate predominantly in the ulcerated lesion. Ultrastructurally, parasitized and lysed eosinophils with dispersion of their granules were seen in the vicinity of parasitized or lysed macrophages.
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ranking = 1
keywords = macrophage
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