Doxium Has Been Proven to Be the Only Oral Agent Available for Delaying the Progression of Diabetic Retinopathy. It Has Also

Doxium has been proven to be the only oral agent available for delaying the progression of diabetic retinopathy. It has also shown benefits in chronic venous insufficiency and haemorrhoids. Product Indications Pack Size DOXIUM 500 Cases of microangiopathy including diabetic retinopathy, 30’s/box capsules. chronic venous insufficiency. As an adjuvant in the treatment of blister-pack Each cap. contains superficial thrombophlebitis, post-thrombotic syndrome, 500mg calcium oedema, stasis dermatitis, circulatory disturbances of dobesilate. arteriovenous origin or due to impaired microcirculation & haemorrhoidal syndrome. ACTIVE PRINCIPLE Calcium 2, 5 dihydroxybenzenesulfonate (Ca dobesilate, INN) PROPERTIES Doxium corrects capillary hyperpermeability and increases capillary resistance. It antagonises the effect of vasoactive substances (histamine, serotonin, bradykinin, prostaglandins and PAF), acts against collagen breakdown, reduces blood hyperviscosity, increases red cell flexibility, diminishes platelet hyperaggregation and improves lymphatic drainage. CONTRA-INDICATIONS No contra-indications known up to now. TOLERABILITY Doxium is particularly well tolerated, even when administered for long-term therapy. It is not toxic; it is practically not metabolized in the body and does not impair hepatic or renal function in any way. It has no effect on arterial blood pressure, blood coagulation or glucose and lipid metabolisms. Doxium has no teratogenic effects and does not cross the placental barrier. Like most drugs, it should not be administered during the first 3 months of pregnancy. Numerous published clinical trials, totaling over 5000 cases, show that the incidence of undesirable side effects is extremely low (3.4%). These usually involve slight digestive disorders. PRESENTATIONS DOXIUM 500, capsules containing 500mg calcium dobesilate. .

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Complete Healing of Venous Leg Ulcer Using a Collagen Based Dressing a Case Report
Case Report Journal of Surgical Techniques and Procedures Published: 30 Jul, 2018 Complete Healing of Venous Leg Ulcer Using a Collagen Based Dressing a Case Report Dumont Isabelle1#, Caillava Celine2#, Dupoiron Stephanie2, Guillemin Yannis2## and Gouze Jean Noel2*## 1Department of Foot and Ankle Surgery, Center of the Foot Ransart, Belgium 2Department of Research and Development, Genbiotech, France #Dumont Isabelle and Caillava Celine Contributed Equally to this Work ##Guillemin Yannis and Gouze Jean Noel are Co-senor Authors Abstract Venous Leg Ulceration (VLU) is a common pathology which affects patients at any age. Ulcers are characterized by long-term healing, pain and frequent recurrence despite adherence to standard of care resulting in time consuming and costly treatments. Here, the authors describe the case of a diabetic, 63 years old male suffering from venous insufficiency and presenting a distal leg ulcer. The ulcer was treated using GBT013 device, a new biocompatible and biodegradable tri-dimensional collagen based matrix. GBT013 seems to be well integrated to the healing tissues and well tolerated. No complication or pain was reported during treatment. Complete healing was obtained within 36 days with no recurrence to date despite a context of stasis dermatitis. Keywords: Venous leg ulcer; Collagen dressing; Tri-dimensional matrix; Wound healing Abbreviations DFU: Diabetic Foot Ulcer; VLU: Venous Leg Ulcer Introduction Venous Leg Ulcers (VLUs) are open lesions of the lower extremities caused by venous disease. OPEN ACCESS Risk factors include all factors susceptible to increase pressure within vessels (e.g., obesity, immobility, thrombosis, varicose veins, and trauma) [1-3]. They are more common in women *Correspondence: and older people and represent 60% to 80% of leg ulcers [4-7].
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Clinical Manifestations and Management of Livedoid Vasculopathy
Clinical Manifestations and Management of Livedoid Vasculopathy Elyse Julian, BS,* Tania Espinal, MBS,* Jacqueline Thomas, DO, FAOCD,** Nason Rouhizad, MS,* David Thomas, MD, JD, EdD*** *Medical Student, 4th year, Nova Southeastern University College of Osteopathic Medicine, Ft. Lauderdale, FL **Assistant Professor, Nova Southeastern University, Department of Dermatology, Ft. Lauderdale, FL ***Professor and Chairman of Surgery, Nova Southeastern University, Ft. Lauderdale, FL Abstract Livedoid vasculopathy (LV) is an extremely rare and distinct hyalinizing vascular disease affecting only one in 100,000 individuals per year.1,2 Formerly described by Feldaker in 1955 as livedo reticularis with summer ulcerations, LV is a unique non-inflammatory condition that manifests with thrombi formation and painful ulceration of the lower extremities.3 Clinically, the disease often displays a triad of livedo racemosa, slow-healing ulcerations, and atrophie blanche scarring.4 Although still not fully understood, the primary pathogenic mechanism is related to intraluminal thrombosis of the dermal microvessels causing occlusion and tissue hypoxia.4 We review a case in which the patient had LV undiagnosed and therefore inappropriately treated for more than 20 years. To reduce the current average five-year period from presentation to diagnosis, and to improve management options, we review the typical presentation, pathogenesis, histology, and treatment of LV.4 Upon physical exam, the patient was found to have the patient finally consented to biopsy. The ACase 62-year-old Report Caucasian male presented in an a wound on the right medial malleolus measuring pathology report identified ulceration with fibrin assisted living facility setting with chronic, right- 6.4 cm x 4.0 cm x 0.7 cm with moderate serous in vessel walls associated with stasis dermatitis lower-extremity ulcers present for more than 20 exudate, approximately 30% yellow necrosis characterized by thick-walled capillaries and years.
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Outcome of Venous Stasis Ulceration When Complicated by Arterial Occlusive Disease
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Eur J Vasc Endovasc Surg 24, 249±254 (2002) doi:10.1053/ejvs.2002.1650, available online at http://www.idealibrary.com on Outcome of Venous Stasis Ulceration when Complicated by Arterial Occlusive Disease W. T. Bohannon, R. B. McLaffertyÃ, S. T. Chaney, M. A. Mattos, L. A. Gruneiro, D. E. Ramsey and K. J. Hodgson Division Vascular Surgery, Department of Surgery, Southern Illinois University, School of Medicine, Springfield, Illinois, U.S.A. Objective: to report the outcome of patients with venous stasis ulceration (VSU) and severe arterial occlusive disease (AOD). Design: retrospective study. Methods: using the International Classification of Diseases (ICD-9), codes for VSU and AOD were cross-matched to identify patients from 1989 to 1999 at two tertiary hospitals. Entry into the study required the presence of a VSU and an ipsilateral procedure to improve AOD or major amputation during the same hospitalisation. Results: fourteen patients (15 extremities) with a mean age of 80 years (range: 47±93) were identified as having VSU and AOD. Mean duration of VSU up to the time of revascularisation or amputation was 6.4 years (range: 4 months±21 years). The mean number of VSUs per extremity was 2.1 and mean wound area was 71 cm2. Mean ankle±brachial index was 0.46 (range: 0.10±0.78). Nine extremities (60%) had a bypass procedure, 3 (20%) had an interventional procedure, 1 (0.6%) had a lumbar sympathectomy, and 2 (13%) had an amputation.
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Cutaneous Manifestations of Abdominal Arteriovenous Fistulas
Cutaneous Manifestations of Abdominal Arteriovenous Fistulas Jessica Scruggs, MD; Daniel D. Bennett, MD Abdominal arteriovenous (A-V) fistulas may be edema.1-3 We report a case of abdominal aortocaval spontaneous or secondary to trauma. The clini- fistula presenting with lower extremity edema, ery- cal manifestations of abdominal A-V fistulas are thema, and cyanosis that had been previously diag- variable, but cutaneous findings are common and nosed as venous stasis dermatitis. may be suggestive of the diagnosis. Cutaneous physical examination findings consistent with Case Report abdominal A-V fistula include lower extremity A 51-year-old woman presented to the emergency edema with cyanosis, pulsatile varicose veins, department with worsening lower extremity swelling, and scrotal edema. redness, and pain. Her medical history included a We present a patient admitted to the hospital diagnosis of congestive heart failure, chronic obstruc- with lower extremity swelling, discoloration, and tive pulmonary disease, hepatitis C virus, tobacco pain, as well as renal insufficiency. During a prior abuse, and polysubstance dependence. Swelling, red- hospitalization she was diagnosed with venous ness, and pain of her legs developed several years stasis dermatitis; however, CUTISher physical examina- prior, and during a prior hospitalization she had been tion findings were not consistent with that diagno- diagnosed with chronic venous stasis dermatitis as sis. Imaging studies identified and characterized well as neurodermatitis. an abdominal aortocaval fistula. We propose that On admission, the patient had cool lower extremi- dermatologists add abdominal A-V fistula to the ties associated with discoloration and many crusted differential diagnosis of patients presenting with ulcerations. Aside from obesity, her abdominal exam- lower extremity edema with cyanosis, and we ination was unremarkable and no bruits were noted.
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Treatment Strategies for Patients with Lower Extremity Chronic Venous Disease (LECVD)
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Stasis Dermatitis
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Stasis Dermatitis
FOR EDUCATIONAL PURPOSES ONLY PRIMARY CARE DIAGNOSTIC INSTITUTE Stasis Dermatitis EPIDEMIOLOGY: Approximately 6-7% in patients older than 50 years ETIOLOGY: Chronic venous insufficiency with venous hypertension PATHOGENESIS: Swelling is caused when plasma (the fluid portion of blood) leaks out of the blood vessels and into the tissues CLINICAL: Reddish-brown skin discoloration HISTOLOGY: Hyperkeratosis, acanthosis, basal pigmentation, and perivascular lymphoid infiltration Stasis Dermatitis is a skin condition caused by fluid building up under the skin, due to poor circulation in the veins (venous insufficiency). The poor circulation will eventually lead to ulcers in the skin. Patients typically pres- ent with an insidious onset of pruritus affecting one or both lower extremities. Reddish-brown skin discoloration is an early sign of stasis dermatitis and may precede the onset of symptoms. Treatment options available are: Elevating the ankle while resting: Compression therapy (generally accomplished by means of specialized stockings that deliver a controlled gradient of pressure) which must be maintained on a lifelong basis. Compression that is more aggressive can be performed by using elastic wraps or compression boots. Topical therapy: Using wet-to-damp gauze dressings soaked with water or with a drying agent, such as aluminum acetate. Topical corticosteroids are frequently used for reducing inflammation and itching in acute flares. BIBLIOGRAPHY 1. “Stasis Dermatitis” (Online) November 2005. http://www.merck.com/mmpe/sec10/ch114/ch114i.html html (visited: March 15, 2008) 2. “Stasis Dermatitis” (Online). February 2007. http://www.emedicine.com/derm/TOPIC403.HTM (visited: March 15, 2008) www.DermpathDiagnostics.com.
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Varicose Veins and Superficial Thrombophlebitis
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Review Skin Changes Are One of the Earliest Signs of Venous a R T I C L E Hypertension
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Practical Approach to Lower Extremity Edema
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Lower Extremity Ulcers: Venous, Arterial, Or Diabetic?
Lower Extremity Ulcers: Venous, Arterial, or Diabetic? Determining the answer to this question is crucial to avoid administering treatment that only makes a serious condition worse. After pointing out where to look for the keys in the history and physical, the authors review how the etiology of an ulcer should influence the therapeutic approach. By Ani Aydin, MD, Srikala Shenbagamurthi, MD, and Harold Brem, MD hen a patient presents to the duration, progression, prior treatments, and clinical emergency department with a course of the ulcer can suggest its etiology. Pos- lower extremity cutaneous ul- sible considerations to rule out include diabetes; cer, many etiologies must be hypertension; hyperlipidemia; coronary artery dis- Wconsidered. These include venous and arterial dis- ease; alcohol and tobacco use; thyroid, pulmonary, ease, diabetes mellitus, connective tissue disorders, renal, neurologic and rheumatic diseases; peripheral rheumatoid arthritis, vasculitis, and malignancies. vascular disease; deep vein thrombosis; and specifi- One goal of the initial assessment is to determine cally cutaneous factors including cellulitis, trauma, whether the ulcer is chronic (defined as taking a and recent surgery. The patient should be asked significant amount of time to heal, failing to heal, about lower extremity pain, paresthesia, anesthesia, or recurring), as such ulcers are associated with sig- and claudication. nificant morbidity.1,2 Physical examination, too, may suggest the etiol- Most prominent in the differential diagno- ogy of an ulcer. Wound characteristics that should sis should be venous reflux, arterial insufficiency, be noted include size, location, margins, presence of pressure ulcer, and ulcer granulation tissue, necrosis, weeping, odor, and pain. >>FAST TRACK<< secondary to diabetic neu- Pulses must be palpated in the distal extremities.
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Stasis Dermatitis Information, Prevention, and Treatment
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