[Modern approach to treatment of trophic ulcers of legs with perifocal varicose eczema, associated with mycotic infection].

During 2005-2007 128 patients at the age from 21 to 80 years with extensive trophic ulcers of legs were treated in the contaminated surgery department of A.V. Vishnevsky Surgery Institute and Korolenko Hospital. In 87 patients (69.9%) varicosity was the cause of venous insufficiency, in 41 patients--post-thrombotic disease. 23 patients (17.97%) had double-sided throphic ulcers. In 50 patients (39.1%) ulcer area exceeded 40 cm2. In microscopical analysis fungi were discovered in 87 patients (89.06%). In the remaining 15 patients diagnosis was verified culturally. System etiotropic antimycotic antibacterial treatment including hyposensitizative, anti-inflammatory, antihistamine drugs was carried out. 34 patients (26.57%) received broad spectrum antibiotic from terbinafine group (Terbizil) in dosage 250 mg once a day during 3 moths with concurrent use of topical antimycotics. 34 patients (26.56%) recieved pulse therapy with broad spectrum antibiotic Rumicoz 400 mg a day during 7 days in combination with topical antimycotics. Nizoral 400 mg a day during 30 days was prescribed to 26 patients (20.3%). 34 patients (26.56%) were treated only with topical antimycotics. After preoperative preparation and reduction of inflammatory process 64 patients had underwent excision of trophic ulcers whereupon the therapy was continued. In these patients regress of varicose eczema manifestation was achieved on the 10th day. In patients who hadn't received surgical cure regress of varicose eczema was signed on the 23-25th day after onset of treatment. Question of plastic closing of throphic ulcers and wounds after their excision was solved particularly. 14 patients needed recurring surgical management becose inflammatory process was continued. Comprehensive approach to therapy taking into account mycotic semination appears to be appropriate and effective. Proactive surgical tactics (excision of throphic ulcer) allows to quicken preoperative preparation for correction of venous blood flow.

[A case of pathomimia]. / Sluchai patomimii.

The authors describe a case of pathomimesis with simulation of seborrheal pemphigus, when the patient was referred to Group II invalidity.

[Endolymphatic antibiotic therapy of allergic vasculitis]. / Endolimfaticheskaia antibiotikoterapiia allergicheskikh vaskulitov.

Inadequacy of the routine methods for therapy of infectious allergic vasculitides and the necessity of sanitizing the foci of infection have prompted the application of endolymphatic administration of antibiotics. Studies of ampicillin pharmacokinetics have demonstrated that a single endolymphatic injection in a dose of 1 x 10(6) U is sufficient to maintain the therapeutic concentration of the drug in the blood serum for 24 hrs. Ampicillin has been injected into the lymph vessels of both soles in the above dose once daily for 5-7 days to 10 patients suffering from allergic vasculitis for a long time. The pathologic elements regressed by the end of the course of therapy in all the cases; only two patients have developed relapses in several months, that have been rapidly arrested.