In the second part of this CME, we present an approach for the management of inflammatory and vaso-occlusive ulcers and highlight the need for further research in this field. The 3 overarching principles for management are etiology-specific treatment, ulcer care, and consideration of patient comorbidities and risk factors for poor healing. Both etiology-specific treatment and management of patient comorbidities and risk factors often require collaboration with providers from other specialties. Ulcer care is governed by tissue debridement, infection control, management of moisture imbalance, and epithelial edge advancement. As wound healing is a dynamic process, management should be adapted to changes in the status of the ulcer.
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http://dx.doi.org/10.1016/j.jaad.2023.12.077 | DOI Listing |
Indian Pediatr
January 2025
Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India. Correspondence to: Dr Anil Kumar Goel, Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Objectives: To compare the efficacy and safety of intravenous (IV) ketorolac and IV morphine in the management of severe vaso-occlusive crisis (VOC) in children with sickle cell disease (SCD).
Method: An open-label, randomized controlled trial was conducted from January 2021 to July 2022 wherein children with SCD aged 3 to 15 years, presenting with severe VOC (score > 6 on the Wong-Baker Faces Pain scale) were included. Block randomization with minimization was done and participants received either IV ketorolac (intervention) or IV morphine infusion (standard).
Br J Haematol
January 2025
Department of Molecular Hematology, Sanquin Research and Landsteiner Laboratory, Amsterdam, the Netherlands.
Ophthalmic Plast Reconstr Surg
December 2024
Moorfields Eye Hospital NHS Foundation Trust, Moorfields Eye Hospital, London, United Kingdom.
Sickle cell disease is known to cause painful vaso-occlusive crises in long bones with large marrows. Orbital infarction is a rare complication of sickle cell disease and usually presents in children and adolescents with acute onset periocular swelling mimicking orbital cellulitis. We describe an atypical case of a 38-year-old man with homozygous sickle cell disease who presented with isolated, complete ptosis of his OD with minimal swelling.
View Article and Find Full Text PDFHaematologica
November 2024
Hematology Center, University of Campinas - UNICAMP, Campinas - São Paulo.
Continuous vaso-occlusive and inflammatory processes cause extensive end-organ damage in adults with sickle cell disease (SCD), and there is little evidence that longterm hydroxyurea therapy prevents this. In initial trials, P-selectin blockade with crizanlizumab reduced SCD vaso-occlusive crisis frequency, and interleukin (IL)-1β inhibition in SCD patients, using canakinumab, lowered inflammatory markers. We used murine SCD models to examine the effects of acute and chronic blockade of Pselectin and of IL-1β on vaso-occlusive events, their inflammatory profile and organ health.
View Article and Find Full Text PDFWest Afr J Med
November 2024
Department of Haematology and Blood Transfusion, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
Introduction: Thrombospondin-1 (TSP-1) is a key protein product of activated platelets which is significantly increased in sickle cell vaso-occlusive crisis (VOC) and other inflammatory conditions. This study aims to determine TSP-1 levels and their relationship with platelet indices and inflammation.
Objective: To evaluate TSP-1 levels in sickle cell anaemia (SCA) patients and assess their relationship with platelet indices and inflammation.
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