Punch grafting for pain reduction in hard-to-heal ulcers.

Objective: Punch-grafting is a traditional technique to enhance wound healing, which has been associated with significant pain reduction. There are few studies measuring pain reduction after punch grafting, our study was designed to measure this outcome.

Method: Patients with hard-to-heal wounds treated with punch grafting were included in a single centre prospective study.

Factitious Ulcer Misdiagnosed as Pyoderma Gangrenosum.

Dermatitis artefacta may represent a real challenge for the clinician. As the patient does not admit self-inflicting the lesions, misdiagnosis with other diseases, such as pyoderma gangrenosum, is common. Consequently, these patients normally go through unnecessary tests and receive potentially harmful treatments as clinicians determine their diagnosis.