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Skin Ulcer

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1. Interventions for ulceration and other skin changes caused by nerve damage in leprosy. (PubMed)

Interventions for ulceration and other skin changes caused by nerve damage in leprosy. At the end of 2016, 145 countries reported to the World Health Organization (WHO) over 173,000 new cases of leprosy worldwide. In the past 20 years, over 16 million people have been treated for leprosy globally. The condition's main complications are injuries and ulceration caused by sensory loss from nerve damage. In this review we explored interventions to prevent or treat secondary damage to the skin (...) existing ulcers, one of them also evaluated prevention of new ulcers. One study aimed to prevent skin changes, such as cracking and fissures. Investigated interventions included: laser therapy, light-emitting diode (LED), zinc tape, intralesional pentoxifylline, pulsed magnetic fields, wax therapy, ketanserin, human amniotic membrane gel, phenytoin, plaster shoes, and footwear.We are uncertain about the following key results, as the certainty of evidence is very low. All time points were measured from

2019 Cochrane

2. Adalimumab (Hyrimoz) - Juvenile Rheumatoid Arthritis, Psoriatic Arthritis, Rheumatoid Arthritis, Ulcerative Colitis, Crohn Disease, Papulosquamous Skin Diseases, Hidradenitis Suppurativa, Ankylosing Spondylitis, Uveitis

Adalimumab (Hyrimoz) - Juvenile Rheumatoid Arthritis, Psoriatic Arthritis, Rheumatoid Arthritis, Ulcerative Colitis, Crohn Disease, Papulosquamous Skin Diseases, Hidradenitis Suppurativa, Ankylosing Spondylitis, Uveitis 1 ANNEX I SUMMARY OF PRODUCT CHARACTERISTICS 2 This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse reactions. See section 4.8 for how (...) have had an inadequate response to conventional therapy including primary nutrition therapy and a corticosteroid and / or an immunomodulator, or who are intolerant to or have contraindications for such therapies. Ulcerative colitis Hyrimoz is indicated for treatment of moderately to severely active ulcerative colitis in adult patients who have had an inadequate response to conventional therapy including corticosteroids and 6-mercaptopurine (6-MP) or azathioprine (AZA), or who are intolerant

2018 European Medicines Agency - EPARs

3. Genital Skin Lesions (Non-Ulcerative)

Genital Skin Lesions (Non-Ulcerative) MANAGEMENT SUMMARY Genital Skin Lesions (Non-Ulcerative) Patient complains of genital skin lump(s) / bump(s) Examination Note the appearance and location of lesions – together with the history, this is usually sufficient to make a diagnosis. Discrete lumps or bumps in the genital region may be due to normal anatomical findings, or may be due to a small number of sexually transmissible infections. Unusual lesions, including pigmented lesions, should (...) be referred for a specialist opinion before any treatment occurs. Normal anatomical variants Males • Pearly penile papules (coronal papillae), Fordyce glands. Females • Vestibular papillomatosis, Fordyce glands Genital warts Exophytic skin lesions that vary in size/shape and number. Males • Typically at leading edge of prepuce, on frenulum, or more sporadically in coronal sulcus, on penile shaft. Less frequently on scrotum or in pubic area or perianal. Females • Usually vulval (often posteriorly

2017 New Zealand Sexual Health Society

4. Comparative effectiveness of skin substitutes for chronic venous leg ulcers in adults: a review of reviews

Comparative effectiveness of skin substitutes for chronic venous leg ulcers in adults: a review of reviews Comparative effectiveness of skin substitutes for chronic venous leg ulcers in adults: a review of reviews Comparative effectiveness of skin substitutes for chronic venous leg ulcers in adults: a review of reviews HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA (...) database. Citation HAYES, Inc. Comparative effectiveness of skin substitutes for chronic venous leg ulcers in adults: a review of reviews. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Health Problem: Venous leg ulcers, also known as venous stasis ulcers or varicose ulcers, are partial or full-thickness defects in the skin of the lower leg, typically between the knee and the ankle, caused by venous hypertension as a result of valvular incompetence and venous reflux

2017 Health Technology Assessment (HTA) Database.

5. Comparative effectiveness of skin substitutes for chronic foot ulcers in adults with diabetes mellitus: a review of reviews

Comparative effectiveness of skin substitutes for chronic foot ulcers in adults with diabetes mellitus: a review of reviews Comparative effectiveness of skin substitutes for chronic foot ulcers in adults with diabetes mellitus: a review of reviews Comparative effectiveness of skin substitutes for chronic foot ulcers in adults with diabetes mellitus: a review of reviews HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment. No evaluation (...) of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Comparative effectiveness of skin substitutes for chronic foot ulcers in adults with diabetes mellitus: a review of reviews. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Health Problem: Diabetes can damage blood vessels, compromising blood flow and oxygen circulation. Resulting tissue hypoxia may contribute to failure of even minor wounds to heal. Reasons are multifactorial and may include

2017 Health Technology Assessment (HTA) Database.

6. Skin grafts may help heal diabetic foot ulcers and reduce amputations

Skin grafts may help heal diabetic foot ulcers and reduce amputations Skin grafts may help heal diabetic foot ulcers and reduce amputations Discover Portal Discover Portal Skin grafts may help heal diabetic foot ulcers and reduce amputations Published on 19 April 2016 doi: Skin grafts and tissue replacement products can help heal diabetic foot ulcers in some cases, and may also slightly reduce the numbers of future amputations. Foot ulcers are common and can be hard to treat, but failure (...) to heal them carries high risk for amputation and mortality. This review showed skin grafts or tissue replacement moderately increased the healing rate of the most amenable diabetic foot ulcers in people with diabetes – that is, in those who had sufficient blood flow in their feet. Two trials reported slightly fewer amputations in people with diabetes compared to usual care at 12 weeks. The review identified the most relevant trial evidence available. These trials showed some limitations. For example

2019 NIHR Dissemination Centre

7. Skin grafts may help heal diabetic foot ulcers and reduce amputations

Skin grafts may help heal diabetic foot ulcers and reduce amputations Skin grafts may help heal diabetic foot ulcers and reduce amputations Discover Portal Discover Portal Skin grafts may help heal diabetic foot ulcers and reduce amputations Published on 19 April 2016 doi: Skin grafts and tissue replacement products can help heal diabetic foot ulcers in some cases, and may also slightly reduce the numbers of future amputations. Foot ulcers are common and can be hard to treat, but failure (...) to heal them carries high risk for amputation and mortality. This review showed skin grafts or tissue replacement moderately increased the healing rate of the most amenable diabetic foot ulcers in people with diabetes – that is, in those who had sufficient blood flow in their feet. Two trials reported slightly fewer amputations in people with diabetes compared to usual care at 12 weeks. The review identified the most relevant trial evidence available. These trials showed some limitations. For example

2018 NIHR Dissemination Centre

8. Skin grafting and tissue replacement for treating foot ulcers in people with diabetes. (PubMed)

Skin grafting and tissue replacement for treating foot ulcers in people with diabetes. Foot ulceration is a major problem in people with diabetes and is the leading cause of hospitalisation and limb amputations. Skin grafts and tissue replacements can be used to reconstruct skin defects for people with diabetic foot ulcers in addition to providing them with standard care. Skin substitutes can consist of bioengineered or artificial skin, autografts (taken from the patient), allografts (taken (...) from another person) or xenografts (taken from animals).To determine the benefits and harms of skin grafting and tissue replacement for treating foot ulcers in people with diabetes.In April 2015 we searched: The Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. We also searched clinical trial registries to identify ongoing

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2016 Cochrane

9. Cadaveric Skin Grafts May Greatly Increase the Healing Rate of Recalcitrant Ulcers When Used Both Alone and in Combination With Split-Thickness Skin Grafts. (PubMed)

Cadaveric Skin Grafts May Greatly Increase the Healing Rate of Recalcitrant Ulcers When Used Both Alone and in Combination With Split-Thickness Skin Grafts. Leg ulcers that do not heal despite appropriate treatment are defined as recalcitrant ulcers. Large surface area, depth, and long duration represent some of most important factors impeding ulcer healing. After sharp debridement, dermal substitutes including skin from cadaver donors may increase the healing rate of recalcitrant ulcers (...) reducing the risk of scar formation and recurrence.Assessing if, after sharp debridement, dermal substitutes including skin from cadaver donors may increase the healing rate of recalcitrant ulcers reducing the risk of scar formation and recurrence.Among patients admitted to our hospital for all types of chronic leg ulcers, we retrospectively reviewed the records of patients affected by recalcitrant ulcers (surface greater than 100 cm, tissue loss involving epidermis, dermis, and subcutaneous tissue

2019 Dermatologic Surgery

10. Prevention of Pressure Ulcers and Skin Degradation in Wheelchair Users: Guidelines

Prevention of Pressure Ulcers and Skin Degradation in Wheelchair Users: Guidelines Prevention of Pressure Ulcers and Skin Degradation in Wheelchair Users: Guidelines | CADTH.ca Find the information you need Prevention of Pressure Ulcers and Skin Degradation in Wheelchair Users: Guidelines Prevention of Pressure Ulcers and Skin Degradation in Wheelchair Users: Guidelines Published on: October 7, 2015 Project Number: RA0810-000 Product Line: Research Type: Devices and Systems Report Type (...) : Reference List Result type: Report Question What are the evidence-based guidelines regarding the management of heat and moisture in seating systems of wheelchair bound individuals? Key Message One evidence-based guideline regarding the management of heat and moisture for pressure ulcer prevention for wheelchair bound individuals was identified. Tags hot temperature, pressure ulcer, skin ulcer, wheelchairs, wounds and injuries, other miscellaneous topics, automated chair, cushion, decubitis, decubitus

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

11. The altered expression of syndecan 4 in the uninvolved skin of venous leg ulcer patients may predispose to venous leg ulcer. (PubMed)

The altered expression of syndecan 4 in the uninvolved skin of venous leg ulcer patients may predispose to venous leg ulcer. Syndecan 4 (SDC4), a heparan sulfate proteoglycan, and neuropilin 1 (NRP1), a transmembrane receptor, are both involved in normal wound healing, but little is known about their possible role in venous leg ulcer pathogenesis. We aimed to investigate whether there are any expression abnormalities and/or gene polymorphisms of SDC4 and NRP1 associated with venous leg ulcer (...) . SDC4 showed significantly lower mRNA and protein expression in the uninvolved dermis of venous leg ulcer patients (n=15) compared with controls (n=15; p=0.0136), while NRP1 showed no expression abnormalities. None of the examined SDC4 and NRP1 polymorphisms showed a difference in their allelic distribution between leg ulcer patients (n=92) and controls (n=92). We hypothesize that SDC4 may play an essential role not only in the inflammation and tissue formation phases of normal wound healing

2017 Wound Repair and Regeneration

12. Randomized, Prospective, Blinded-Enrollment, Head-To-Head Venous Leg Ulcer Healing Trial Comparing Living, Bioengineered Skin Graft Substitute (Apligraf) with Living, Cryopreserved, Human Skin Allograft (TheraSkin). (PubMed)

Randomized, Prospective, Blinded-Enrollment, Head-To-Head Venous Leg Ulcer Healing Trial Comparing Living, Bioengineered Skin Graft Substitute (Apligraf) with Living, Cryopreserved, Human Skin Allograft (TheraSkin). Chronic venous leg ulcers are responsible for significant morbidity and health care costs worldwide. This pilot study evaluated the effectiveness 2 biologically active grafts, TheraSkin and Apligraf, in conjunction with compression therapy. The study, not industry-sponsored

2018 Clinics in podiatric medicine and surgery Controlled trial quality: uncertain

13. Palliative care - malignant skin ulcer

Palliative care - malignant skin ulcer Palliative care - malignant skin ulcer - NICE CKS Share Palliative care - malignant skin ulcer: Summary A malignant ulcer is a proliferative or cavitating primary or secondary cancer in the skin. It may appear as a crater-like wound, a nodular 'fungus', or a 'cauliflower' lesion. Most malignant ulcers develop from a breast, head and neck, or skin cancer. Malignant ulcers are most likely to develop in people older than 70 years of age with metastatic cancer (...) and a life expectancy of 6 months or less. Primary care management of a malignant skin ulcer includes: Assessment of the malignant skin ulcer including the type, site and size of the ulcer, the presence of necrotic tissue, condition of the surrounding skin, and the presence of complications. Discussing with the person their concerns, treatment priorities, and advising that healing is unlikely to be a realistic goal, but that the aim is to maintain the person’s quality of life as much as possible

2018 NICE Clinical Knowledge Summaries

14. Skin grafting for venous leg ulcers. (PubMed)

Skin grafting for venous leg ulcers. Venous leg ulceration is a recurrent, chronic, disabling condition. It affects up to one in 100 people at some time in their lives. Standard treatments are simple dressings and compression bandages or stockings. Sometimes, despite treatment, ulcers remain open for months or years. Sometimes skin grafts are used to stimulate healing. These may be taken, or grown into a dressing, from the patient's own uninjured skin (autografts), or applied as a sheet (...) pads with an autograft delivered on porcine gelatin microbeads, the fifth trial (92 participants) compared a meshed graft with a cultured keratinocyte autograft, and the sixth trial (50 participants) compared a frozen keratinocyte allograft with a lyophilised (freeze-dried) keratinocyte allografts.Significantly more ulcers healed when treated with bilayer artificial skin than with dressings. There was insufficient evidence from the other trials to determine whether other types of skin grafting

2013 Cochrane

15. Ambiguous skin ulcer on the ear pinna. (PubMed)

Ambiguous skin ulcer on the ear pinna. Cutaneous leishmaniasis (CL) is a parasitic disease which has a biphasic life cycle; infection by promastigotes from the sandfly reaches a wound where it is phagocytosed by macrophages, producing the amastigote (the Leishmania donovani body) in the host. A protozoan parasite transmitted by the phlebotomous sandfly causes human leishmaniasis. Cutaneous forms include classical cutaneous, mucocutaneous and post-kala-azar dermal leishmaniasis. It affects c (...) . 300 million individuals in more than 90 nations around the globe. The cutaneous form in the Old World is caused at low altitudes mainly by L. major (which has an animal reservoir, rodents such as mouse) and in swampy regions and high altitudes by L. tropica (which has no animal reservoir). L. aethiopica and L. major lead to disseminated ulcers in Saudi Arabia, Yemen, Iraq, Iran, Pakistan, India, Tunisia, Sudan and Ethiopia, whose main electrophoretic isozyme pattern Zymodeme in Saudi Arabia is LON

2019 Tropical Doctor

16. The healing effect of Wharton's jelly stem cells seeded on biological scaffold in chronic skin ulcers: A randomized clinical trial. (PubMed)

The healing effect of Wharton's jelly stem cells seeded on biological scaffold in chronic skin ulcers: A randomized clinical trial. Chronic wound or nonhealing ulcer is essentially a wound that does not progress normally through the wound healing process. This study assessed the healing effect of umbilical cord Wharton's jelly stem cells seeded on biological scaffold in chronic skin ulcers.In a randomized clinical trial, five patients between 30 and 60 years with chronic diabetic wounds were (...) the healing effect in chronic diabetic wounds, they can be an alternative source in tissue engineering and repair of chronic ulcers.© 2019 Wiley Periodicals, Inc.

2019 Journal of cosmetic dermatology Controlled trial quality: uncertain

17. Zinc deficiency exacerbates pressure ulcers by increasing oxidative stress and ATP in the skin. (PubMed)

Zinc deficiency exacerbates pressure ulcers by increasing oxidative stress and ATP in the skin. Zinc deficiency is believed to be a predisposing factor for the development and intractable healing of pressure ulcers (PUs); however, the mechanisms of this association have not been elucidated.Objective was to elucidate the mechanisms of the formation of severe and prolonged PUs under the zinc deficiency condition.We assessed PUs formation after cutaneous ischemia-reperfusion (I/R) injury in mice (...) stress, and apoptosis induced by cutaneous I/R injury. I/R injury-induced oxidative stress signals were significantly higher in ZD OKD48 mice than in ZA OKD48 mice. Additionally, zinc deficiency reduced the number of LCs and increased the amount of ATP in cutaneous I/R-injured skin. Oral supplementation of zinc improved zinc deficiency-associated PUs.Zinc deficiency might increase cutaneous I/R injury-induced vascular damages, oxidative stress, and apoptosis, as well as ATP amount in I/R area due

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2019 Journal of dermatological science

18. Matched-Cohort Study Comparing Bioactive Human Split-Thickness Skin Allograft plus Standard of Care to Standard of Care Alone in the Treatment of Diabetic Ulcers: A retrospective analysis across 470 institutions. (PubMed)

Matched-Cohort Study Comparing Bioactive Human Split-Thickness Skin Allograft plus Standard of Care to Standard of Care Alone in the Treatment of Diabetic Ulcers: A retrospective analysis across 470 institutions. This retrospective, matched-cohort study analyzed 1,556 patients with diabetic ulcers treated at 470 wound centers throughout the United States to determine the effectiveness of a cryopreserved bioactive split-thickness skin allograft plus standard of care when compared to standard (...) deep structures (p = .036), and/or Wagner Grade 4 ulcers (p = 0.04). Furthermore, the decrease in recidivism was statistically significant at 3 months, 6 months, and 1 year, with and without initially exposed deep structures (p < .05). The amputation rate in the treatment cohort was 41.7% less than that of the control cohort at 20 weeks (0.9% vs 1.5%, respectively). This study demonstrated that diabetic ulcers treated with a cryopreserved bioactive split-thickness skin allograft were more likely

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2019 Wound Repair and Regeneration

19. Systematic review of the use of biological skin substitutes in venous leg ulcers

Systematic review of the use of biological skin substitutes in venous leg ulcers Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing

2018 PROSPERO

20. The evidence for the use of growth factors and active skin substitutes for the treatment of non-infected diabetic foot ulcers (DFU): a health technology assessment (HTA)

The evidence for the use of growth factors and active skin substitutes for the treatment of non-infected diabetic foot ulcers (DFU): a health technology assessment (HTA) The evidence for the use of growth factors and active skin substitutes for the treatment of non-infected diabetic foot ulcers (DFU): a health technology assessment (HTA) The evidence for the use of growth factors and active skin substitutes for the treatment of non-infected diabetic foot ulcers (DFU): a health technology (...) assessment (HTA) Buchberger B, Follmann M, Freyer D, Huppertz H, Ehm A, Wasem J CRD summary This review concluded that add-on therapy with growth factors or active skin substitutes could be an alternative to standard wound care alone for treatment of diabetic foot ulcers, but their use could not be explicitly recommended without stronger evidence. These conclusions appropriately reflect the limitations of the evidence presented. Authors' objectives To assess the safety and effectiveness of growth factors

2011 DARE.

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