Differential diagnosis and therapy of leg ulcers

2011 ◽  
Vol 9 (12) ◽  
pp. 1035-1052 ◽  
Author(s):  
Volker Meyer ◽  
Nina Kerk ◽  
Stefanie Meyer ◽  
Tobias Goerge
2004 ◽  
Vol 35 (01) ◽  
Author(s):  
S Springer ◽  
S Bechthold ◽  
A Jansson ◽  
K Kurnik ◽  
T Pfluger ◽  
...  

2014 ◽  
Author(s):  
Nicole Nigro ◽  
Bettina Winzeler ◽  
Isabelle Suter-Widmer ◽  
Philipp Schuetz ◽  
Birsen Arici ◽  
...  

Dermatology ◽  
2018 ◽  
Vol 234 (5-6) ◽  
pp. 194-197
Author(s):  
Jean-Benoît Monfort ◽  
Karine Cury ◽  
Philippe Moguelet ◽  
François Chasset ◽  
Claude Bachmeyer ◽  
...  

Background: The histological characteristic of hypertensive leg ulcers (HLU) is the presence of “arteriolosclerosis.” The pertinence of performing a skin biopsy to diagnose HLU is questionable, as cutaneous arteriolosclerosis may be related to patient comorbidities. The objective here was to evaluate the frequency of arteriolosclerosis in skin leg biopsies performed in patients without ulcer and in control patients with HLU. Methods: We performed a retrospective study between January 2013 and July 2014. Patients were included if they had undergone a deep skin biopsy on the lower limbs, in the absence of any leg ulcer. Controls were patients with typical HLU. Results: Fifty-eight patients and 6 controls were included. Hypertension was present in 25 patients (43%). Arteriolosclerosis, defined as fibrous endarteritis, was present in 35 out of 58 patients (60%) and in all of the controls. No hyalinosis or hyperplastic proliferative arteriolosclerosis was observed in the patients or controls. Only age was an independent factor associated with the presence of cutaneous arteriolosclerosis (p &x#3c; 0.0001). Conclusion: Cutaneous arteriolosclerosis is significantly and independently associated with age. Thus, skin biopsy seems not to be necessary for the diagnosis of HLU but only for a differential diagnosis.


Author(s):  
Petros Bouras-Vallianatos

This chapter examines John’s Medical Epitome. The focus here is on the first four of its six books. In contrast to the established view that this work was intended for physicians, it is argued that it was primarily written for philiatroi, intellectuals who were deeply interested in medicine, but not practising physicians themselves. The Medical Epitome, unlike John’s other two works, mainly consisted of material from earlier sources. The analysis of the text starts with a close reading of John’s proem and a discussion of the background of his dedicatee, the Byzantine statesman Alexios Apokaukos. It then shifts to an examination of the work’s structure with the aim of emphasizing John’s intentions in putting together his material. The analysis proceeds by way of a number of case studies focusing on diagnosis and therapy, and goes on to show that John intentionally condensed his material, removing specialized advice, so as to make it appeal to non-expert readers. Thus it is shown, for example, that the absence of details on invasive operations is consistent with the character of his intended readers, who were only able to use non-invasive techniques, such as phlebotomy and arteriotomy. Finally, the particular attention John paid to differential diagnosis, especially as regards eye affections, which is often supplemented with his own advice, is highlighted.


2008 ◽  
Vol 65 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Thomas Imfeld

Rund jede vierte Person hat Mundgeruch. Dabei muss zwischen Foetor ex ore (90%) und Halitosis (10%) unterschieden werden. Ersterer ist nur im Mundatem perzeptierbar und hat seine Ursache in der Mundhöhle. Halitosis ist im Mund- und/oder Nasenatem feststellbar und die Ursache liegt entweder nasal/pharyngeal (lokale Halitosis nur im Nasenatem), pulmonal oder selten gastrointestinal (systemische Halitosis im Mund- und Nasenatem). Eine entsprechende Differenzialdiagnose ist Voraussetzung für die Kausaltherapie. Verantwortlich für den Foetor ex ore sind flüchtige Schwefelverbindungen, welche durch proteolytische Mikroorganismen in der Mundhöhle produziert werden. Prophylaxe und Therapie basieren auf der mechanischen und chemischen Reduktion dieser Erreger. Mundgeruch kann ein nachhaltiges soziales Handikap sein, weshalb das Thema nicht tabuisiert werden darf.


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