Difference between revisions of "Pressure ulcer"

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====Micro====
====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.
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.   
 
There is no epidermal nuclear atypia. Mitotic activity is not apparent.


==References==
==References==

Revision as of 19:03, 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:

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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.

There is no epidermal nuclear atypia. Mitotic activity is not apparent.

References

  1. 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.
  2. 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.
  3. 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.
  4. Simmons, MA.; Edwards, JM.; Nigam, A. (Dec 2000). "Marjolin's ulcer presenting in the neck.". J Laryngol Otol 114 (12): 980-2. PMID 11177375.

See also