MyMedR

Leong LLY

Family Practitioner, 1978;3:10-11.

Matched MeSH terms: Skin Ulcer

Tropical ulcers: the first imported cases and review of the literature

Veraldi S, Faraci AG, Valentini D, Bottini S

Eur J Dermatol, 2021 Feb 01;31(1):75-80.

PMID: 33648916 DOI: 10.1684/ejd.2021.3968

BACKGROUND: A tropical ulcer is a bacterial necrotizing disease of the skin, with an acute or chronic clinical course, caused by anaerobic bacteria, notably Fusobacteria spp.

OBJECTIVES: We present six Italian tourists who acquired tropical ulcers in tropical and subtropical countries.

MATERIALS & METHODS: Four males and two females acquired a skin ulcer during trips to Brazil, Malaysia, Fiji Islands, Zambia, Tanzania and India. In all patients, medical history, physical and dermatological examination, laboratory tests, bacteriological examinations and biopsy were carried out.

RESULTS: All patients were in good general health. All patients stated that the ulcer was caused by a trauma. No fever was reported. Neither lymphangitis nor lymphadenopathy were detected. The ulcer was located on a forearm in one patient, on a leg in two and on an ankle in three patients. All ulcers were malodorous and painful. Laboratory tests revealed mild leucocytosis and a mild increase in erythrocyte sedimentation rate and C-reactive protein. Results of bacteriological examinations revealed the presence of Fusobacterium spp. in five patients. Other bacteria were identified in all patients. Histopathological examination showed: necrosis of the epidermis and dermis; vascular dilatation; oedema in the dermis; massive infiltration with neutrophils, lymphocytes and histiocytes; and fragmented collagen bundles. No signs of vasculitis were observed. All patients were successfully treated with oral metronidazole (1 g/day for two weeks) and, according to antibiograms, with different systemic antibiotics.

CONCLUSION: To our knowledge, these are the first cases of tropical ulcers reported in Western tourists.

Matched MeSH terms: Skin Ulcer/microbiology*; Skin Ulcer/pathology*

Fulltext Acute Marjolin's Ulcer in Chronic Foot Wounds with Previous Negative Biopsy: Report of Two Cases

Xu S, Kang Y, Soeharno H, Yeo N

Malays Orthop J, 2020 Nov;14(3):194-197.

PMID: 33403086 DOI: 10.5704/MOJ.2011.033

Marjolin's ulcer is a rare and often overlooked diagnosis which can be encountered by a variety of specialities. Majority of the literatures describe long latency period of 11 to 75 years. The authors present two unusual cases of rapid progression to Marjolin's ulcer in patients with previously negative biopsy 8- and 10-month prior. This highlights the importance for clinicians to have a high degree of suspicion when encountered with any non-healing wound, especially one who's symptomatology and morphological features have undergone an acute change. Even with previous negative biopsy, patients should still be followed-up closely and clinicians should not hesitate to perform re-biopsy if the suspicion arises.

Matched MeSH terms: Skin Ulcer

Subcutaneous mycosis presenting as a non- healing left calf ulcer in an immunocompromised patient

Tang ASO, Yong KY, Wong J, Chua HH, Chew LP

Med J Malaysia, 2017 04;72(2):122-123.

PMID: 28473676

This is a case report of subcutaneous mycosis presenting as a non-healing left calf ulcer in an immunocompromised patient. Traumatic inoculation of the causative agent is the most likely route of infection. The diagnosis requires a detailed history and high clinical suspicion, confirmed by histopathological examination. The management requires a multidisciplinary team approach involving surgeon, pathologist, physician sub-specialised in infectious disease, wound care nursing team as well as social support services. The literature review recommended that the treatment of choice for such infection is surgical debridement in addition to optimal antifungal therapy.

Matched MeSH terms: Skin Ulcer/diagnosis*; Skin Ulcer/etiology; Skin Ulcer/pathology

Increasing productivity with smartphone digital imagery wound measurements and analysis

Nair HKR

J Wound Care, 2018 Sep 01;27(Sup9a):S12-S19.

PMID: 30207849 DOI: 10.12968/jowc.2018.27.Sup9a.S12

OBJECTIVE: The primary aim was to determine the productivity increase using digital imagery for better documentation and analysis. A case series was done in a specialised care centre with patients managed with advanced dressings and using state-of-the-art smartphone technology for documentation to save costs and time.

METHOD: Wounds were cleansed and debrided before using the application to photograph, document, measure and analyse the wounds. The smartphone app was oriented parallel to the plane of the wound, where possible, to obtain accurate measurements. A longitudinal study report was generated for each wound and showed the progress of the wound healing until the wound was closed.

RESULTS: A sample size of 60 patients consisting of wounds from different locations, and a total of 203 measurements and analyses were conducted over a period of seven months. The wound monitoring app proved to be effective for wound monitoring and required less than two hours' training. A report summary of wounds recorded could also be generated automatically through the dashboard. All 60 patients' cases were automatically recorded, measured and presented into reports for use in clinical analysis. There was a significant time savings (27 hours per day for a specialised care centre with 10 nurses) increase over manual wound documentation and measuring methods.

CONCLUSION: The app provided a non-contact, easy to use, reliable and accurate smart wound management solution for clinicians and physicians to track wound healing in patients. The app could also be used by patients and caregivers for home monitoring of their wounds.

Matched MeSH terms: Skin Ulcer/economics; Skin Ulcer/pathology*; Skin Ulcer/rehabilitation

Fulltext Marjolin's ulcer--a near forgotten entity

Tan BC, Horton TC, Sara Ahmad T

Med J Malaysia, 2006 Feb;61 Suppl A:91-3.

PMID: 17042239

We report a case of a 55-year-old man who presented with a 6-month history of a fungating ulcer on the right hand at the site of a previously healed ulcer that had been present for 40 years. Histopathological examination of four-quadrant biopsy specimens showed a moderately differentiated squamous cell carcinoma (SCC). A transradiocarpal amputation with stump closure using radial flap was performed as it was not possible to achieve a functionally and cosmetically acceptable hand after a wide excision with 2 cm tumour-free margin. It is our intention to highlight this rare condition as reminder to consider this entity as a differential diagnosis of chronic non-healing skin ulcer.

Matched MeSH terms: Skin Ulcer/diagnosis*; Skin Ulcer/etiology; Skin Ulcer/surgery

A treatment of perforating ulcers in leprosy

Mehta H

Journal of the Malaya Branch of the British Medical Association, 1938;2:88-90.

Matched MeSH terms: Skin Ulcer

Fulltext A skin lesion and fever of unknown origin - a case study

Wong S, Ng CJ

Aust Fam Physician, 2012 Jan-Feb;41(1-2):41-4.

PMID: 22276283

Matched MeSH terms: Skin Ulcer/etiology*; Skin Ulcer/pathology

Histiocytosis X and vulvar ulceration

Wong KK, Lin HP, Looi LM

Int J Gynaecol Obstet, 1992 Oct;39(2):131-4.

PMID: 1358712

Vulvar ulceration is a rare manifestation of histiocytosis X. A 13-year-old girl had a nonhealing vulvar ulcer for 1 year. She had been in remission from histiocytosis X and the ulcer was not recognised as a sign of disease recurrence until tissue biopsy was obtained for histopathological and immunohistochemical studies. This article stresses the importance of establishing an accurate diagnosis when chronic vulvar ulcers are encountered and reviews the literature on this uncommon presentation of histiocytosis X.

Matched MeSH terms: Skin Ulcer/etiology*; Skin Ulcer/pathology

Methotrexate toxicity presenting as ulcerated psoriatic plaques

Wong SM, Chong YT, Thevarajah S, Baba R

Australas J Dermatol, 2012 Feb;53(1):81-3.

PMID: 22309341 DOI: 10.1111/j.1440-0960.2011.00779.x

Methotrexate toxicity is known to cause erosions of existing psoriatic plaques, although rare. We describe two patients who developed painful ulcerated psoriatic plaques as an early presenting sign of methotrexate toxicity and review the risk factors associated with this manifestation.

Matched MeSH terms: Skin Ulcer/chemically induced*; Skin Ulcer/diagnosis

Fulltext Sézary syndrome in a Malay--case report and literature review

Yuen P, Chan HL, Lee YS

Singapore Med J, 2001 May;42(5):224-7.

PMID: 11513062

Sézary syndrome is a rare form of primary cutaneous T cell lymphoma. It is a distinct systemic variant of mycosis fungoides, marked by erythroderma, lymphadenopathy and circulating cerebriform lymphocytes in the peripheral blood. We report a case of Sézary syndrome in a 61-year-old Malay man with a five-year history of indurated plaques, ulcers and tumours on the head and trunk, with characteristic findings on physical examination, skin biopsy, electron microscopy, immunophenotyping and peripheral blood film. A literature review on Sézary syndrome is presented.

Matched MeSH terms: Skin Ulcer/etiology; Skin Ulcer/pathology*

Rituximab for refractory digital infarcts and ulcers in systemic sclerosis

Khor CG, Chen XL, Lin TS, Lu CH, Hsieh SC

Clin Rheumatol, 2014 Jul;33(7):1019-20.

PMID: 24722688 DOI: 10.1007/s10067-014-2579-1

Systemic sclerosis is an uncommon connective tissue disease characterised by excessive deposition of collagen and vasculopathy which affects the skin and multiple internal organs. It is associated with autoimmunity, inflammation, vasculopathy and fibrosis. Managing Raynaud's phenonemon, digital infarcts and ulcers in systemic sclerosis patients is often a challenge particularly among rheumatologists. We report a case of systemic sclerosis patient with refractory digital infarcts and ulcers responded successfully with rituximab.

Matched MeSH terms: Skin Ulcer/complications; Skin Ulcer/drug therapy*

Syringomyelic neuropathic ulcer of the elbow: treatment with an external fixator

Yeap JS, Wallace AL

J Shoulder Elbow Surg, 2003 Sep-Oct;12(5):506-9.

PMID: 14564278 DOI: 10.1016/S1058-2746(03)00168-X

Matched MeSH terms: Skin Ulcer/etiology; Skin Ulcer/surgery

Pulmonary actinomycosis and skin sinuses

Lee JK

J Paediatr Child Health, 2007 Dec;43(12):854-5.

PMID: 18036023

A 12-year old girl presented with an unusual problem of recurrent discharging multiple skin sinuses on her right anterior and posterior chest wall for a year. There was ipsilateral lower lobe pneumonia and imaging showed multiple abscesses in her lower back muscles bilaterally. A purulent fluid was aspirated from her back muscles and the histology examination showed sulphur granules with gram positive branched filaments. She responded well to the treatment for actinomycosis with penicillin and doxycycline.

Matched MeSH terms: Skin Ulcer/diagnosis*; Skin Ulcer/drug therapy; Skin Ulcer/microbiology

Fulltext The use of durable barrier cream in preventing pressure ulcer

Mazlinda, M., Ayu Sulaini, J., Suriawati, G., Mardiana, M., Zahri, M.K.

The Malaysian Journal of Nursing, 2018;9(3):13-17.

MyJurnal

A pressure ulcer is a common health problem, particularly among the physically limited or bedridden individuals. The most vulnerable group to suffer this condition is the elderly. The prevalence of Geriatric inpatient with pressure ulcer stage I, II, III or even IV for a month was 35.5% of the total admission. The understanding of recovery process, prevention remains the best management strategy as it improves their quality of life. This study aims to compare PU development outcomes in geriatric patients nursed on either using the Durable barrier cream (Cavillon cream) or non-pharmacological intervention alone. Using the Quasi experimental study-design, the selected participants were subjected to Cavaillon cream as well as the intervention. The assessment used were the outcome of the pressure ulcer was assessed using the measured size of the redness area. There was the statistically significant reduction in pressure ulcer size on day three compared to the size on day one among the intervention group, z value was -5.028, p

Matched MeSH terms: Skin Ulcer

Fulltext Chromobacterium violaceum septicaemia in Malaysia

Sagin DD, Tan PT, Dolkadir J

Singapore Med J, 1994 Aug;35(4):426.

PMID: 7899912

Matched MeSH terms: Skin Ulcer/microbiology

Arginine glutamate improves healing of radiation-induced skin ulcers in guinea pigs

Khalin I, Kocherga G

Int J Radiat Biol, 2013 Dec;89(12):1108-15.

PMID: 23786463 DOI: 10.3109/09553002.2013.817698

The increase in the incidence of the radiation-induced skin injury cases and the absence of standard treatments escalate the interest in finding new and effective drugs for these lesions. We studied the effect of a 40% solution of arginine glutamate on the healing of radiation-induced skin ulcers in guinea pigs.

Matched MeSH terms: Skin Ulcer/drug therapy*; Skin Ulcer/etiology

Chronic nonhealing ulcer of the right thumb with multiple subcutaneous nodules

Manohar A, Nizlan MN

Orthopedics, 2008 Jul;31(7):710.

PMID: 19292371

A 60-year-old man presented with a 3-month history of nonhealing ulcer over the tip of his right thumb. The ulcer started as a blister over the tip of the thumb that later ruptured and spread proximally to cover the whole pulp area of the thumb. There was no history of trauma, fever, weight loss, or loss of appetite. He is a pensioner and an avid gardener. He has a few cats as pets. The patient initially presented to a private orthopedic surgeon with a nonhealing ulcer of the right thumb. Multiple debridements were unsuccessful in ameliorating the ulcer. Three months after the onset of the initial lesion, multiple painless erythematous nodules had developed on his right arm, and one on the right thigh. All routine blood investigations were nondiagnostic. Swab culture from the ulcer failed to grow any organism and a course of antibiotics did not resolve the problem. Cultures of the biopsy specimen using Sabouraud's dextrose agar and potato carrot medium grew dark brown plaques that microscopically appeared to be branching hyphae. A diagnosis of sporotrichosis of the right upper limb was made and the patient was started on antifungal treatment immediately (T. Itraconazole [Sporanox] 200 mg BD). One month after commencement of antifungal treatment, the ulcer began to dry up and at 3 months all the lesions including the one on the right thigh had healed.

Matched MeSH terms: Skin Ulcer/diagnosis*; Skin Ulcer/drug therapy*

Diabetic artefacts in forensic practice

Murty OP

J Forensic Leg Med, 2009 May;16(4):218-23.

PMID: 19329080 DOI: 10.1016/j.jflm.2008.07.010

A case is presented where confusion arose about skin lesions and whether they were diabetic or electrical in origin. The deceased was a known diabetic and hypertensive man. A middle-aged person in early fifties was found unconscious in the cell and judicial autopsy was performed. He was facing trial for capital punishment of being allegedly involved in drug trafficking and money laundering. He had few marks over his fingers and foot which were considered to be electric marks produced in electric torture. also had fracture of skull and ischemic necrosis of right side of cerebrum; and contrecoup lesions. Findings are documented with photographs of the lesions. The article also depicts photographs of the scene where the victim had fallen and sustained skull fracture.

Matched MeSH terms: Skin Ulcer/etiology; Skin Ulcer/pathology*

Systemic sclerosis in Sarawak: a profile of patients treated in the Sarawak General Hospital

Teh CL, Kuan YC, Wong JS

Rheumatol Int, 2009 Aug;29(10):1243-5.

PMID: 19373465 DOI: 10.1007/s00296-009-0938-z

We performed a cross-sectional study of the demography, clinical and laboratory features of patients with systemic sclerosis patients followed up in our centre from 1984 to 2007. There were 23 cases with the majority of them (96%) being female. They have a mean age of 50.3 years and a mean disease duration of 6.02 (SD 5.82) years. Our patients comprised of multi-ethnic groups with predominantly Chinese (52%), Sarawak natives (35%) and Malays (13%). They have a mean lag time to diagnosis of 24.8 (SD 34.8) months. All the patients have sclerodermatous skin changes with 16(70%) having diffuse scleroderma and 7(30%) having limited scleroderma. The common clinical manifestations found in our patients were Raynaud's phenomenon (91%), sclerodactyly (65%), digital ulcers (52%) and pulmonary fibrosis (52%). There was low incidence of pulmonary hypertension (13%) and renal involvement (4%). The majority of our patients (67%) have positive ANA with 33% positive Scl-70. The majority received calcium channel blockers (87%), aspirin (48%) and low-dose prednisolone (48%). One patient developed adenocarcinoma of the lung on follow-up. This study demonstrated the rarity of systemic sclerosis in our centre with considerable lag time to diagnosis in our patients. Diffuse cutaneous systemic scleroderma is more common in our centre with rare pulmonary hypertension and renal involvement.

Matched MeSH terms: Skin Ulcer/diagnosis*

Displaying publications 1 - 20 of 24 in total