ABSTRACT
An adult diabetic male with three toes amputated on his right foot presented with an ulcer infection on his left foot, unresponsive to conventional antifungal oral medication for over two months. The ulcerated foot wound had a large impairment on the patient's quality of life, as determined by the Wound-QoL questionnaire. The compounding pharmacist recommended and the physician prescribed two topical compounded medicines, which were applied twice a day, free of charge at the compounding pharmacy. The foot ulcer infection was completely resolved following 13 days of treatment, with no longer any impairment on the patient's quality of life. This scientific case study highlights the value of pharmaceutical compounding in current therapeutics, the importance of the triad relationship, and the key role of the compounding pharmacist in diabetes care.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Antifungal Agents/administration & dosage , Diabetic Foot/drug therapy , Vasodilator Agents/administration & dosage , Vitamin B Complex/administration & dosage , Wound Healing/drug effects , Wound Infection/drug therapy , Administration, Cutaneous , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/chemistry , Anti-Inflammatory Agents, Non-Steroidal/economics , Antifungal Agents/adverse effects , Antifungal Agents/chemistry , Antifungal Agents/economics , Clotrimazole/administration & dosage , Cost Savings , Cost-Benefit Analysis , Diabetic Foot/diagnosis , Diabetic Foot/economics , Diabetic Foot/microbiology , Drug Combinations , Drug Compounding , Drug Costs , Humans , Ibuprofen/administration & dosage , Male , Metronidazole/administration & dosage , Middle Aged , Nifedipine/administration & dosage , Pantothenic Acid/administration & dosage , Pantothenic Acid/analogs & derivatives , Time Factors , Treatment Outcome , Vasodilator Agents/adverse effects , Vasodilator Agents/chemistry , Vasodilator Agents/economics , Vitamin B Complex/adverse effects , Vitamin B Complex/chemistry , Vitamin B Complex/economics , Wound Infection/diagnosis , Wound Infection/economics , Wound Infection/microbiologyABSTRACT
A cútis laxa granulomatosa é variante de linfoma T cutâneo com características histopatológicas semelhantes às da micose fungóide, além da presença de infiltrado granulomatoso e perda de fibras elásticas. Caracteriza-se clinicamente por placas endurecidas, eritêmato-vinhosas, que evoluem para flacidez cutânea, acometendo preferencialmente as regiões axilar e inguinal. Em mais da metade dos casos há associação com linfoma de Hodgkin. Relata-se o caso de paciente de 47 anos com cútis laxa granulomatosa, com manifestação sistêmica, que respondeu parcialmente à terapia com interferon-alfa e corticosteróides.
Granulomatous slack skin is a cutaneous T cell lymphoma variant with histopathologic findings similar to those of mycosis fungoides, in addition to granulomatous infiltrate and loss of dermal elastic tissue. Clinically, it begins with indurated purplish plaques that evolve into areas of hanging bulky skin masses, preferentially affecting axillary and inguinal folds. In more than half of cases there is an association with Hodgkins disease. Here, we report the case of a 47-year-old woman with granulomatous cutis laxa and systemic manifestations that partially responded to therapy with interferon alpha and steroids.
ABSTRACT
Leucemias agudas necessitam de suporte hemoterápico para serem tratadas adequadamente. A presença do anticorpo anti-Lutheran B e a alta freqüência do antígeno em nossa população dificulta o tratamento de doenças hematológicas que necessitam de suporte transfusional, tais como a leucemia linfóide aguda (LLA). Alternativas de tratamento hemoterápico são abordadas neste artigo. Descreve-se o caso de uma paciente com LLA e anticorpo anti-Lutheran B. A dificuldade em encontrar sangue compatível levou os autores a adotarem estratégia conservadora no tratamento hemoterápico. O uso de eritropoetina e a adoção de protocolo quimioterápico individualizado viabilizaram os resultados obtidos.
Acute leukemia needs hemotherapeutic support to be successfully treated. The Lutheran B antibody, specifically the high frequency of this antigen in our population, has made it difficult to treat hematological malignancies that need transfusional support, including acute lymphoblastic leukemia. Finding compatible blood is complex and so the authors adopted a conservative treatment strategy. The prescription of epoetin and an individualized chemotherapy protocol may improve results. We describe a case report of a patient with anti-Lutheran B antibody and how difficulties to find compatible blood were solved.
