Bhutani Sourabh, Verma Rohit, Verghese George
Graded Specialist Marine Medicine, INS Shankul, C/o Fleet Mail Office, Mumbai 400001, India.
Graded Specialist Marine Medicine & PMO, Diving School, Naval Base, Kochi 682004, India.
Med J Armed Forces India. 2012 Oct;68(4):389-91. doi: 10.1016/j.mjafi.2012.01.002. Epub 2012 Jul 17.
Livedoid vasculopathy is an uncommon condition resulting in painful lower extremity ulceration and scarring. This condition presents as purpuric macules and papules that progress to painful, irregular ulcers of the lower legs and dorsal feet. These ulcerations are often recurrent and chronic with spontaneous remissions and exacerbations that may be seasonal. The first case, a 22-year-old female presented with three-year history of recurrent multiple non-healing ulcers involving feet and ankles. The ulcers were associated with severe debilitating pain and paraesthesia, as a result of which she was unable to walk without support. Patient was administered HBOT at pressure of 2.5ATA for 1 h daily, six days a week. After ten sittings of HBOT, patient reported a drastic reduction in the pain along with reduction in the dose of analgesic by half and a definite improvement in her walking. The second case was a 49-year-old male who also had history of recurrent ulceration on the dorsum of feet and ankles associated with severe pain. With HBOT, the patient felt an improvement in pain and ambulation by the 8th sitting and complete relief from pain by the 17th sitting. HBOT is a recognized modality of treatment of various problem wounds and non-healing ulcers due to various etiologies. The above two cases show that it can be a useful treatment modality for livedoid vasculopathy where other treatment modalities have failed and therefore could be given to a larger number of patients in hospitals where it is available.
萎缩性硬化性苔藓样血管病是一种罕见的疾病，可导致下肢疼痛性溃疡和瘢痕形成。这种疾病表现为紫癜性斑疹和丘疹，进而发展为小腿和足背部疼痛性、不规则溃疡。这些溃疡常反复发作且呈慢性，有自发缓解和加重，可能具有季节性。首例患者为一名22岁女性，有3年反复发作的累及足部和踝部的多处不愈合溃疡病史。这些溃疡伴有严重的衰弱性疼痛和感觉异常，因此她在没有支撑的情况下无法行走。患者接受高压氧治疗，压力为2.5ATA，每天1小时，每周6天。经过10次高压氧治疗后，患者报告疼痛大幅减轻，镇痛药剂量减半，行走能力有明显改善。第二例患者为一名49岁男性，也有足部和踝部背侧反复发作溃疡并伴有严重疼痛的病史。通过高压氧治疗，该患者在第8次治疗时感觉疼痛和行走能力有所改善，在第17次治疗时疼痛完全缓解。高压氧治疗是治疗各种问题伤口和由各种病因引起的不愈合溃疡的一种公认方法。上述两个病例表明，对于萎缩性硬化性苔藓样血管病，在其他治疗方法失败的情况下，高压氧治疗可能是一种有用的治疗方式，因此在有条件的医院可以应用于更多患者。
