ABSTRACT
Las úlceras flebostáticas son las más frecuentes en los miembros inferiores y constituyen una de las complicaciones más graves de la insuficiencia venosa crónica. Se caracterizan por ser invalidantes y tener alta repercusión socioeconómica. El objetivo de este trabajo es revisar los aspectos más relevantes de la epidemiología, la clínica y del tratamiento de las úlceras flebostáticas. Para la exploración bibliográfica se realizaron búsquedas de artículos en las bases de datos informatizadas on-line Medline, Cochrane Library, artículos publicados en páginas web, revistas líderes en la publicación de estudios sobre úlceras flebostáticas, el Consenso Latinoamericano sobre Úlceras Venosas, las Guías Prácticas de la Sociedad de Cirugía Vascular y el Fórum Americano de Flebología. Las úlceras flebostáticas son las más frecuentes de los miembros inferiores, más comunes en el sexo femenino y en mayores de 60 años. Repercuten en la calidad de vida del paciente y los gastos sanitarios. No existe tratamiento único para ellas, por lo que en un paciente se usan varios tratamientos o su combinación. Las evidencias científicas apuntan hacia las terapias compresivas como de primera línea. A pesar de los avances tecnológicos realizados en el tratamiento de estas úlceras, así como la gran variedad de los mismos, donde se complementan los más modernos con los ya existentes, las úlceras flebostáticas son de difícil curación y de alta recurrencia(AU)
The phlebostatic ulcers are the most common in the lower limbs and represent the most serious complications of the chronic venous insufficiency. These ulcers are disabling and have a significant social and economic impact. The objective of this paper was to review the most outstanding aspects of the epidemiology, the clinical manifestations and the treatment of the phlebostatic ulcers. The literature search was made in Medline, Cochrane Library, articles published in different web pages, leading journals in the publication of studies about phlebostatic ulcers, Latin American Consensus on Venous Ulcers, Practice Guidelines of the Society for Vascular Surgery and the American Venous Forum. The phlebostatic ulcers are the most frequent in the lower limbs, mainly in females and in patients older than 60 years. They have an impact on the quality of life of patients and on health expenditures. There is not a unique treatment for this type of ulcers, so several therapies or a combination of them is used. The scientific evidences point to the compressive therapies as the first-line method. Despite the technological advances in the treatment of these ulcers, and their great variety, in which the already existing ones and the latest ones complement each other, these ulcers are difficult to be cured and highly recurrent(AU)
Subject(s)
Humans , Varicose Ulcer/complications , Venous Insufficiency/complications , Venous Insufficiency/drug therapy , Databases, BibliographicABSTRACT
Livedo vasculitis is one of the most difficult dermatological diseases to cope with in routine clinical practice. We report the case of a 23-year-old woman, who was diagnosed with livedo vasculitis and was responsive to Kampo treatment. She had a rash-like bruise from the spring of X-2, being diagnosed with livedo vasculitis at another hospital. In April, X, painful multiple ulcers on both lower limbs were beginning to appear and were resistant to the western standard therapy. In May 6,X, we started Kampo therapy for her at our hospital. After 4 months, her painful ulcers disappeared. We used tokishigyakukagoshuyushokyoto as the main agent, along with kakobushimatsu, hainoto, senkinnaitakusan, hakushusan and tokishakuyakusan. Although her livedo symptoms still remain and may need long-term treatment to heal completely, she obtained relief from painful ulcers, returning to her normal daily life.