[Arteriovenous malformations: study about 54 patients]. / Malformations arterioveineuses: etude de 54 patients.

BACKGROUND: Arteriovenous malformation (AVM) are vascular anomalies that may threaten functional and vital prognosis. The aim of this study was to assess the managment of Arteriovenous malformation METHODS: It is a retrospective study about 54 patients, having AVM, collected over a 7-year period. RESULTS: Sex ratio MJF was 1.25; average age at the diagnosis was 25.4 years. Puberty, pregnancy and trauma, were the most important favoring factors for the development of AVM. Location was the head in 75% of the cases. Doppler ultrasound was the most indicated examination to confirm the diagnosis. In over than 70% of our patients, therapeutic abstention and follow-up were indicated. In the other cases, embolization, with or without surgery was the treatment. A patient died of massive haemorrhage. Treatment is necessary in complicated AVM. Follow-up (if abstention or after treatment) is mainly based on clinical and Doppler data. CONCLUSIONS: AVM are anomalies that may be serious and their management must be multidisciplinary, to allow better therapeutic indications.

[Leg ulcer in a patient treated with hydroxyurea for polycythemia vera]. / Ulcère de jambe chez une malade traitée par hydroxyurée pour maladie de Vaquez.

INTRODUCTION: Causes of leg ulcers vary widely, although venous insufficiency and peripheral arteriopathy are most common. Ulcers are much rarer in patients treated by hydroxyurea. CASE: A 66-year-old woman who had been treated with hydroxyurea for polycythemia vera for four years came to our consultation a month after ulceration of the left lateral malleolus had begun. Symmetric peripheral pulses were present and there was no patent venous insufficiency. After two months of local symptomatic treatment, the size of the ulcer had increased. The possible involvement of hydroxyurea in the genesis and maintenance of this leg ulcer was then considered. Hydroxyurea was stopped, and the ulcer progressively grew smaller, finally healing completely two months later. DISCUSSION: We conclude that hydroxyurea was the primary cause of the malleolar ulcer, for it healed rapidly when this treatment stopped. Hydroxyurea causes cutaneous atrophy; when followed by microtrauma, associated with deterioration in DNA repair mechanisms, it may lead to the formation of persistent cutaneous ulcers. Hydroxyurea can also affect the microcirculation and induce tissular anoxia, which may also explain both the occurrence of cutaneous ulcers after microtrauma and their often painful character.