Background: Post-kala-azar dermal leishmaniasis (PKDL) is an uncommon complication of visceral leishmaniasis (VL) but is emerging as an increasingly frequent and serious complication of acquired immunodeficiency syndrome (AIDS). It manifests as a macular, morbilliform, or nodular eruption in a patient who has recovered from VL.
Methods: We present two cases of PKDL in the setting of AIDS.
Chronic nonhealing wounds, such as venous ulcers (VUs), are a widespread and serious medical problem with high morbidity and mortality. The molecular pathology of VUs remains poorly understood, impeding the development of effective treatment strategies. Using mRNA expression profiling of VUs biopsies and computational analysis, we identified a candidate set of microRNAs with lowered target gene expression.
View Article and Find Full Text PDFA critical question in the treatment of chronic wounds is whether and when debridement is needed. The three most common chronic wounds are the diabetic foot ulcer (DFU), the venous leg ulcer, and the pressure or decubitus ulcer. Surgical debridement, aimed at removing necrotic, devitalized wound bed and wound edge tissue that inhibits healing, is a longstanding standard of care for the treatment of chronic, nonhealing wounds.
View Article and Find Full Text PDFAdv Wound Care (New Rochelle)
February 2012
Background: Stress-induced disruption of hormonal balance in animals and humans has a detrimental effect on wound healing.
The Problem: After the injury, keratinocytes migrate over the wound bed to repair a wound. However, their nonmigratory phenotype plays a role in pathogenesis of chronic wounds.
Glucocorticoids (GCs) are known inhibitors of wound healing. In this study we report the novel finding that both keratinocytes in vitro and epidermis in vivo synthesize cortisol and how this synthesis regulates wound healing. We show that epidermis expresses enzymes essential for cortisol synthesis, including steroid 11 β-hydroxylase (CYP11B1), and an enzyme that controls negative feedback mechanism, 11β-hydroxysteroid dehydrogenase 2 (11βHSD2).
View Article and Find Full Text PDFDiabetic foot ulcers are a common problem in clinical practice and one of the most common complications in diabetic patients, often leading to amputation and hospitalization. Although there are a number of options for coadjuvant therapy for diabetic foot ulcers, a considerable number of patients remain unhealed after 12 weeks of treatment and, in general, rates of healing remain low. For these reasons, as well as the rising costs of associated complications of nonhealing diabetic foot ulcers, there is an impetus for the research community to develop more sophisticated ways to manage this condition.
View Article and Find Full Text PDFAn estimated 15% of patients with diabetes mellitus will develop a foot ulcer during their lifetime. Debridement is included in multiple guidelines and algorithms for the care of patients with diabetic neuropathic foot ulcers, and it has long been considered an essential step in the protocol for treating diabetic foot ulcers. In addition to altering the environment of the chronic wound, debridement is a technique aimed at removing nonviable and necrotic tissue, thought to be detrimental to healing.
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