Difference between revisions of "Pressure ulcer"
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*[[Squamous cell carcinoma of the skin]]. | *[[Squamous cell carcinoma of the skin]]. | ||
**Known as a ''Marjolin's ulcer'' when arising in the context of long standing inflammation.<ref name=pmid11177375>{{Cite journal | last1 = Simmons | first1 = MA. | last2 = Edwards | first2 = JM. | last3 = Nigam | first3 = A. | title = Marjolin's ulcer presenting in the neck. | journal = J Laryngol Otol | volume = 114 | issue = 12 | pages = 980-2 | month = Dec | year = 2000 | doi = | PMID = 11177375 }}</ref> | **Known as a ''Marjolin's ulcer'' when arising in the context of long standing inflammation.<ref name=pmid11177375>{{Cite journal | last1 = Simmons | first1 = MA. | last2 = Edwards | first2 = JM. | last3 = Nigam | first3 = A. | title = Marjolin's ulcer presenting in the neck. | journal = J Laryngol Otol | volume = 114 | issue = 12 | pages = 980-2 | month = Dec | year = 2000 | doi = | PMID = 11177375 }}</ref> | ||
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<pre> | |||
SKIN LESION ("DECUBITUS ULCER"), EXCISION: | |||
- SKIN ULCERATION WITH REACTIVE CHANGES (CONSISTENT WITH PRESSURE ULCER). | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
====Micro==== | |||
The sections show skin with acanthosis, hypergranulosis, compact hyperkeratosis and focal full thickness loss of the epidermis, associated with a mixed inflammatory infiltrate. The dermis has reactive fibroblasts with moderate grey cytoplasm, nuclear enlargement and round small nucleoli. Fibroblast nuclei have regular nuclear membranes and a bland chromatin pattern. Small clusters of neutrophils are present. Mitotic activity is not apparent. | |||
==References== | ==References== | ||
Revision as of 18:54, 10 November 2012
Pressure ulcer, also known as decubitus ulcer (as it often arises from lying down, i.e. being decubitus, a long time), is a relatively common ditzel.
General
- Common, esp. in spina bifida,[1] individuals with spinal cord injuries.
Etiology:
Microscopic
Features:
- Ulceration - full thickness loss of the epidermis.
- Inflammation - lymphocytes, plasma cells, neutrophils.
- +/-Abscess formation - clusters of extravascular neutrophils.
DDx:
- Squamous cell carcinoma of the skin.
- Known as a Marjolin's ulcer when arising in the context of long standing inflammation.[4]
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SKIN LESION ("DECUBITUS ULCER"), EXCISION:
- SKIN ULCERATION WITH REACTIVE CHANGES (CONSISTENT WITH PRESSURE ULCER).
- NEGATIVE FOR MALIGNANCY.
Micro
The sections show skin with acanthosis, hypergranulosis, compact hyperkeratosis and focal full thickness loss of the epidermis, associated with a mixed inflammatory infiltrate. The dermis has reactive fibroblasts with moderate grey cytoplasm, nuclear enlargement and round small nucleoli. Fibroblast nuclei have regular nuclear membranes and a bland chromatin pattern. Small clusters of neutrophils are present. Mitotic activity is not apparent.
References
- ↑ Nthumba, PM. (2010). "Marjolin's ulcers: theories, prognostic factors and their peculiarities in spina bifida patients.". World J Surg Oncol 8: 108. doi:10.1186/1477-7819-8-108. PMID 21129225.
- ↑ Olesen, CG.; de Zee, M.; Rasmussen, J. (Jun 2010). "Missing links in pressure ulcer research--an interdisciplinary overview.". J Appl Physiol 108 (6): 1458-64. doi:10.1152/japplphysiol.01006.2009. PMID 20299616.
- ↑ Hamanami, K.; Tokuhiro, A.; Inoue, H. (Feb 2004). "Finding the optimal setting of inflated air pressure for a multi-cell air cushion for wheelchair patients with spinal cord injury.". Acta Med Okayama 58 (1): 37-44. PMID 15157010.
- ↑ Simmons, MA.; Edwards, JM.; Nigam, A. (Dec 2000). "Marjolin's ulcer presenting in the neck.". J Laryngol Otol 114 (12): 980-2. PMID 11177375.