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Abstract
Vasculitis is a rare cause of skin ulceration. Depending on the size of the affected vessel, the patient's comorbidities and the pathophysiology present, different clinical morphologies can be seen, which can often give preliminary indications of the type of underlying vasculitis. There may be systemic or cutaneous manifestations; thus, a targeted diagnostic workup should be initiated at an early stage. Treatment should be interdisciplinary if there is systemic participation. Vasculopathies (e.g., livedoid vasculopathy), in which occlusion of the vascular lumen is the main pathophysiological feature, should be delimitated from vasculitis. If vasculitic or vasculopathic ulceration is present, stage-appropriate wound management is recommended.
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Affiliation(s)
- C Mitschang
- Klinik fürHautkrankheiten, Universitätsklinikum Münster, Von-Esmarch-Str. 58, 48149, Münster, Deutschland.
| | - T Görge
- Klinik fürHautkrankheiten, Universitätsklinikum Münster, Von-Esmarch-Str. 58, 48149, Münster, Deutschland.
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Dörfler P, Bauer W, Görge T, Luger T, Rappersberger K, Stingl G, Stockinger T, Stütz A, Wolff-Winiski B. 694 Comparative analysis of cytokines, proteases and growth factors in human wound exudates obtained by vacuum therapy. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Reich-Schupke S, Alm J, Altmeyer P, Bachter D, Bayerl C, Beissert S, Bieber T, Böhmer J, Dill D, Dippel E, Dücker P, Effendy I, El Gammal S, Elsner P, Enk A, Feldmann-Böddeker I, Frank H, Gehring W, Gieler U, Goebeler M, Görge T, Gollnick H, Grabbe S, Gross G, Gudat W, Happ A, Herbst R, Hermes B, Hoff NP, John SM, Jungelhülsing M, Jünger M, Kaatz M, Kapp A, Kaufmann R, Klode J, Knaber K, König A, Krieg T, Kohl P, Kowalzick L, Lehmann P, Löffler H, Maschke J, Marsch W, Mechtel D, Mohr P, Moll I, Müller M, Nashan D, Ockenfels HM, Peter RU, Pillekamp H, Rompel R, Ruzicka T, Salfeld K, Sander C, Schaller J, Scharffetter-Kochanek K, Schuler G, Schulze HJ, Schwarz T, Splieth B, Stege H, Stolz W, Strölin A, Tran H, Tronnier M, Ulrich J, Vogt T, Wagner G, Welzel J, Willgeroth T, Wollina U, Zillikens D, Zouboulis CC, Zuberbier T, Zutt M, Stücker M. [Phlebology in German departments of dermatology. An analysis on behalf of the German Society of Phlebology]. Hautarzt 2013; 64:685-94. [PMID: 24022632 DOI: 10.1007/s00105-013-2623-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Phlebologic diseases have become extremely common and have major socio-economic impact. However, the percentage of dermatologists working in phlebology appears to be decreasing according to the data of the German Society of Phlebology (DGP). METHODS To investigate the reasons for this development, we--on behalf of the DGP--sent a questionnaire to 120 German Departments of Dermatology in autumn 2012. RESULTS In 76 returned questionnaires, the number of physicians with additional fellowship training in phlebology averaged 1.5; the average number of those who fulfill the criteria for training fellows in phlebology was 0.9. In 71.1 % of the departments there was a phlebologist. A special phlebologic outpatient clinic existed in 73.7 % of the departments. Sonography with Doppler (89.5 %) and duplex (86.8 %) was used as the most frequent diagnostic tool. For therapy, compression (94.7 %), sclerotherapy (liquid 78.9 %, foam 63.2 %, catheter 18.4 %), endoluminal thermic procedures (radio wave 28.9 %, laser 17.1 %) and surgery (especially crossectomy and stripping 67.1 %, phlebectomy of tributaries 75 %) were used. The average number of treatments was very heterogenous in the different departments. CONCLUSIONS Phlebology definitely plays an important role in dermatology. Most departments fulfill the formal criteria for the license to conduct advanced training in phlebology. A wide spectrum of phlebological diagnostic and therapeutic procedures is available.
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Affiliation(s)
- S Reich-Schupke
- Klinik für Dermatologie, Venerologie und Allergologie, Venenzentrum der Dermatologischen und Gefäßchirurgischen Kliniken, Ruhr-Universität Bochum, Hiltroper Landwehr 11-13, 44805, Bochum, Deutschland,
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Abstract
The coagulation system protects the body from uncontrolled blood loss by means of highly regulated processes. In case of an injury the coagulation system instantly switches from controlled blood flow to acute coagulation and thrombus formation with the goal of stopping the blood loss. Minor changes in this well-maintained equilibrium of coagulation and blood flow tip the balance towards uncontrolled blood loss or even fatal thromboembolic events. Iatrogenic manipulation of this highly regulated system is possible with a variety of therapeutic agents. We review the basics of coagulation physiology and then discuss dermatologically relevant aspects of thrombosis prevention, as well as the use of anticoagulants to treat dermatologic diseases.
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Affiliation(s)
- V Meyer
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Münster, von Esmarchstr. 58, 48149, Münster, Deutschland
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Schneider SW, Ossig R, Görge T, Matzke R, Rogge P, Niemeyer A, Oberleithner H. Docking and fusion sites in human endothelial cells imaged and measured by using atomic force microscopy. Exp Dermatol 2008. [DOI: 10.1111/j.0906-6705.2004.0212az.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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