12 research outputs found
Pressure heel ulcers in patients with type 2 diabetes: Is it T.I.M.E. to customise wound bed preparation according to different heel areas?
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Honey dressing on a leg ulcer with tendon exposure in a patient with type 2 diabetes
No full textHoney has been used as a wound dressing for hundreds of years by ancient civilizations, but only recently it has acquired scientific interest because of its relevant biological properties. In the last decade, indeed, several trials and observational studies have reported that, compared to conventional treatment (e.g. antiseptics, polyurethane film, paraffin gauze, soframycin-impregnated gauze), honey dressings seem to be better in healing time of different types of wounds, including diabetic foot ulcers. However, to date, information about a potential favorable biological effect of honey dressings on diabetic ulcers with exposed tendon are still scarce. Notably, foot or leg ulcers with exposed tendon are serious complications in patients with type 2 diabetes, as they are associated with an increased risk of adverse outcome. Therefore, the use of effective and safe treatments to bring these lesions to timely healing is very important in clinical practice. We herein report the case of a Caucasian adult patient with type 2 diabetes presenting a chronic right posterior lower limb ulcer (Texas University Classification (TUC) 2D) with tendon exposure that was successfully treated with honey dressings (glucose oxidase (GOX) positive with peroxide activity) in addition to systemic antibiotic therapy, surgical toilette and skin graft. In our case, the use of honey dressing for treating exposed tendon tissue probably allowed the timely wound healing. Although further studies are required, such treatment may constitute part of the comprehensive management of diabetic wounds, including those with tendon exposure, and should be considered by clinicians in clinical practice
Cutaneous squamous carcinoma in a patient with diabetic foot: an unusual evolution of a frequent complication
No full textAfter basal cell carcinoma, the cutaneous squamous cell carcinoma (cSCC) is the second most frequent non-melanoma skin cancer worldwide, and, classically, arises from the upper coats of the epidermis of sun-exposed areas or from skin areas constantly exposed to a chronic inflammatory stimulus. The occurrence of cSCC seems to be linked to several factors, including exposure to sunlight (or other ultraviolet radiations), immunosuppression, chronic scarring conditions and some familial cancer syndromes. Although the majority of cSCCs are adequately eradicated by surgical excision, a subgroup of cSCC may be linked with an increased risk of recurrence, metastasis and death. The incidence of type 2 diabetes mellitus is constantly increasing worldwide. Importantly, diabetes mellitus is a strong risk factor for cancers (including cutaneous tumors) and is highly related with poor cancer outcomes. At present, in the literature, squamous cell carcinoma developing in association with diabetic foot ulcers has been already reported in some reports; however, additional data are needed to make the clinicians aware of this rare, although possible, complication. Therefore, we herein report an unusual case of an elderly man with T2DM and a positive oncological history, presenting a cSCC involving the skin overlying the first toe of left foot. The growing cSCC appeared approximately 3 years after the appearance of a diabetic ulcer
The Appropriateness of Footwear in Diabetic Patients Observed during a Podiatric Examination: A Prospective Observational Study
No full textBackground: Adequate compliance with wearing therapeutic footwear (TF) to prevent diabetic foot ulcers is known to be low. The primary aim of this study was to identify population awareness about the ulceration and/or recurrence risk according to footwear choice. The secondary aim was to evaluate the compliance level in footwear choice based on a patient’s own risk. Methods: Forty podiatrists participated from 1 September 2017 to 31 August 2018, providing six-section forms which included personal data, risk classification, footwear characteristics and a knowledge questionnaire. Results: This study included 1507 patients. Those with active ulcers were excluded. A total of 43% of patients belonged to risk class 0, 19% to risk class 1, 19% to risk class 2 and 19% to risk class 3. A total of 58% had foot deformities. Conclusions: Nearly half of patients with a high risk of ulceration had knowledge of their own risk but the majority of them did not follow the recommendations. Only a small percentage (36%) of risk class 3 patients wore footwear suitable for their risk class. There was poor consideration of footwear choice among patients. We highlight critical issues in patient education and compliance with wearing footwear appropriate to their risk class
Primary cutaneous B-cell lymphoma and chronic leg ulcers in a patient with type 2 diabetes
No full textThe incidences of type 2 diabetes mellitus and many cancers are rapidly increasing worldwide. Diabetes is a strong risk
factor for some cancers (including lymphomas) and is also associated with adverse cancer outcomes. After gastrointestinal
tract, the skin is the second most frequent extranodal site involved by non-Hodgkin lymphomas and the cutaneous B-cell
lymphomas (CBCLs) range from 25% to 30% of all primary cutaneous lymphomas. The primary cutaneous diffuse large
B-cell lymphoma (PCDLBCL) is an aggressive lymphoma with a poor prognosis, representing roughly 20% of all primary
CBCLs. Classically, the cutaneous manifestation of this lymphoma is a red or violaceous tumors arising on a leg. To date,
despite the large body of evidence suggesting that diabetes is strongly associated with an increased risk of some cancers,
very little information is available regarding a possible association between type 2 diabetes and primary cutaneous
diffuse large B-cell lymphoma. In this report, we will present the case of a white adult patient with type 2 diabetes with
chronic leg ulcers complicated by a primary cutaneous diffuse large B-cell lymphoma
Distribution of high valence Fe sites in nickel–iron hydroxide catalysts for water oxidation
No full textDifferential diagnosis of unipolar versus bipolar depression by GSK3 levels in peripheral blood: a pilot experimental study
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