Department of Plastic and Reconstructive Surgery, Centro Hospitalar Universitario de Lisboa Central, Lisbon, Portugal.
Department of Nephrology, Centro Hospitalar Universitario de Lisboa Central, Lisbon, Portugal.
Wounds. 2022 Aug;34(8):E63-E65. doi: 10.25270/wnds/20115.
Stasis dermatitis is a pathologic condition of the skin that most commonly occurs in the lower limb, where it is caused by chronic venous insufficiency. Stasis dermatitis of the upper limb is rare.
A 45-year-old male, resident in Angola, presented to the emergency department with an ulcer encompassing the entire left forearm. Past medical history comprised arterial hypertension and end stage renal disease treated with hemodialysis. Dialysis access consisted of a left brachial-basilic AV graft obtained 4 years before. The patient also reported that a right internal jugular vein catheter was used previously during the maturation of the left brachial-basilic AV graft. Stenosis of the left brachiocephalic vein was documented at angiography. Angioplasty was performed, with complete resolution of the wound 2 months after admission.
The differential diagnosis of extensive ulcer of the forearm must include neoplasms, cellulitis, and/or deep tissue infection with secondary ulceration, but it is also important to maintain suspicion for venous stasis syndrome as a rare but possible cause of these lesions.
淤滞性皮炎是一种皮肤病理状况，最常发生于下肢，由慢性静脉功能不全引起。上肢淤滞性皮炎则较为罕见。
一名 45 岁男性，安哥拉居民，因左前臂全范围溃疡到急诊就诊。既往病史包括动脉高血压和终末期肾病，接受血液透析治疗。透析通路为 4 年前获得的左肱动脉-贵要静脉动静脉移植物。患者还报告称，在左肱动脉-贵要静脉动静脉移植物成熟过程中，曾使用过右侧颈内静脉导管。血管造影显示左侧头臂静脉狭窄。进行了血管成形术，入院后 2 个月伤口完全愈合。
前臂广泛溃疡的鉴别诊断必须包括肿瘤、蜂窝织炎和/或深部组织感染伴继发性溃疡，但也必须保持对静脉淤滞综合征的怀疑，因为这是这些病变罕见但可能的原因。
