Complete healing and short-term treatment by Argania honey dressing in a venous leg ulcer: case report

Background: Recent advances in care aware that inadequate management of the healing process in wounds and the development of bacterial infections leads to increase morbidity. Health professionals have progressively recognized the value of choosing suitable dressings to manage wounds particularly in developing countries. Honey has been used for thousands of years as a wound dressing and considered as biologic treatment due to its multiple bioactivities related to healing process. Objective: The aim of this case report is to demonstrate that Argania Honey dressing improve the healing process in a venous leg ulcer. Method: Pure raw Argania honey (Argania spinosa, endemic tree in southwestern of Morocco) with no additives, pasteurization, or manipulation was used and provided from local beekeepers. A mechanical debridement process was achieved previously to the application of honey dressings to a venous leg ulcer of a 67-year-old woman affected by type II diabetes for 11 years. Results : The Argania honey dressing accompanied by mechanical debridement process demonstrated a rapid recovery and complete healing of the wound for 12 weeks approximately (79 days). Conclusion: This Moroccan honey (Argania) experienced for the first time in venous leg ulcer management may represent a good alternative to treat other types of wounds. Further investigations by using Argania honey dressing are required to explain its effect and the mechanisms involved in the improvement of healing process.

Solitary cecal ulcer - case report and treatment options according to literature review

Introduction. Solitary cecal ulcer is a benign and extremely rare disease, as less than 300 cases have been reported so far. The etiology is unknown, and it can be diagnosed by pathohistological examination. Often presented as an acute abdomen and rectal bleeding, it can mock various important and urgent conditions. Treatment protocol is not defined. Extensive and radical surgeries are often performed due to this benign disease mimic. Our aim was to indicate this disease, present the treatment of this rare condition, and to facilitate the treatment plan for this disease. Case outline. Female, aged 67, was admitted to the Emergency Department with a clinical manifestation of acute appendicitis. Emergency surgery was indicated after following diagnostic tests. The intraoperative finding revealed an ulcer on the cecum, which was sutured. The patient fully recovered, and subsequent colonoscopy and pathohistological findings indicated a solitary ulcer. Conclusion. It is possible to treat this condition by retaining the organ and avoiding major surgery. Therefore, it is our opinion that it might provide significant assistance to clinicians in a similar situation. Hence, it is undoubtedly an interesting case for archiving, especially since such a case has not been recorded in our country yet.

Lipschutz Ulcer in A Virgin Woman: A Case Report

Background: Lipschutz ulcer, also known as vulvae acutum ulcer, is an acute ulcer in the vulva. The aetiology and pathogenesis of Lipschutz ulcer are unclear, but it is known to be associated with infectious diseases such as Mycoplasma infection, paratyphoid fever, influenza A, and most infections with Epstein-Barr virus (EBV). This ulcer appears in adolescent females aged 14–20 years old, with 70% of cases occurring in virgin women. Purpose: To review the causes of non-Sexually Transmitted Diseases (STD) ulcers, so clinicians can establish an accurate diagnosis and rational therapy; therefore, minimizing the psychological impact on the patient due to possible misdiagnosis of STD-induced ulcer. Case: A painful wound in the genital area of a 20-year-old virgin woman. She was diagnosed with Lipshutz ulcer and vulvovaginal candidiasis based on the anamnesis, physical examination, and laboratory examination obtained from vaginal discharge using potassium hydroxide, Gram staining, and blood test to exclude genital ulcer caused by the sexually transmitted agent. A blood test was taken, including the serological tests for syphilis and genital herpes. Tests for EBV were also performed. The patient was treated only with single-dose fluconazole 150 mg orally and saline compress on the ulcer. Genital ulcer and vaginal discharge improved one week after treatment. Discussion: Lipshutz ulcer management is symptomatic, usually self-limiting, and disappears spontaneously within 1–2 weeks without recurrences. It can also occur as a single lesion with possible coinfection of other agents, for example, candidiasis, which in this case, requires treatment of comorbidities. Hygiene factors play an essential role in preventing occurrence of the secondary infection and further development of the disease. Conclusion: The diagnosis of Lipshutz ulcer is mainly based on clinical manifestation after excluding several possible ulcers that can affect the genital area, including sexually transmitted infections.

Spindle Cell Melanoma Presenting as an Ulcer in a Black Diabetic

Background. Melanoma in blacks is uncommon and exceedingly rare in association with a diabetic ulcer. We present a case of a spindle cell melanoma masquerading as a diabetic ulcer. Case Report. A 57-year-old overweight woman presented to The Maria Holder Diabetes Centre for the Caribbean with a nonhealing ulcer of the right heel after being treated by various primary care physicians over the preceding year. Her general and systematic examinations were unremarkable. There was a 1 × 1.5 cm ulcer with a necrotic base which bled easily on contact with no evidence of peripheral neuropathy nor arterial insufficiency. Microscopic examination of a biopsy of the lesion showed fascicles of spindle cells with plump nuclei and intracytoplasmic yellow-brown pigment. Immunohistochemistry confirmed a diagnosis of melanoma. Discussion. There should be a high index of suspicion of malignancy with nonhealing diabetic ulcer especially when coupled with short disease duration. This case highlights the importance of a biopsy and histological evaluation in ulcers presenting in recently diagnosed diabetics with no evidence of peripheral neuropathy or vascular disease. Melanoma should be considered in spindle cell lesions especially with pigment and residual nevus cells.

Effect of Trishothadi Lepam on Tropical foot ulcer – Case Report

Siravyadhana and Trishothadi Lepam application was intended for healthy wound healing. Probably it will have an understanding of underlying mechanism of relieving vascular stasis, reducing venous congestion and beginning of re-vascularization and other wound healing process. The Group-B showing maximum percentage of benefit followed by Group-A. Hence it can be concluded that overall benefit is found maximum in Group-A where Siravyadhana with Trishothadi Lepam was administered. The drug Trishothadi Lepam might be shown the efficacy due to Lekhana, Kledahara, Shoshana, Shotha & Dahahara, RaktaShodhaka and Twaka Prasadana properties. this procedure is found to be very much safe, simple, cost-effective, easily administered in the patients of foot ulcers leading them for complete healing avoiding the most unwanted outcome of amputation.