[Necrotic angiodermatitis: treatment by early cutaneous grafts].

INTRODUCTION

Necrotic angiodermitis is an uncommonly hypertensive ischemic ulceration. It usually occurs on the legs in elderly, hypertensive and sometimes diabetic patients. Its extensive and highly painful nature is characteristic. Currently, there is no simple effective treatment which is known to stop the development. We report the results of a patch graft method applied early before the angiodermitis develops into an advanced stage.

PATIENTS AND METHODS

The technique was used in 13 consecutive patients with 16 episodes of necrotic angiodermitis. The graft was made 8 days (mean) after hospitalization.

RESULTS

The analgesic effect of the graft was apparent within the first days after the graft. The violet halo of extension disappeared a mean of 8 days after the graft. A second or even third graft was required in 8 of 16 episodes. Total cicatrization was obtained after a mean delay of 33 days.

CONCLUSION

Patch graft is a simple, low-cost, non invasive treatment which can be performed at the bedside and even in an outpatient clinic. This stops the extension of the necrotic angiodermitis and controls pain. Delay to cicatrization is shorter. The favourable effect of the graft could possibly be mediated by vasodilator peptides liberated by the graft tissue which would counteract the hypothetical vasospasm.