PMC8630374_01
Physical examination showing eunuchoid body proportions, obesity, long extremities, gynecomastia, scanty pubic hairs, small testes (A and B). Shallow ulcer with yellow necrotic tissue on the lower-left leg and atrophie blanche on both lower legs (C). Varicose veins with hyperpigmented indurated skin appear on both lower legs (D and E).
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Physical examination revealed obesity (height: 175 cm, weight: 97 kg, body-mass index: 31.7 kg/m2), eunuchoid body proportion, gynecomastia, increased fat distribution around the hip and thighs, scanty pubic hairs, and small testes [Figure 1A and B]. Both of his lower legs showed varicose veins [Figure 1D and E]. A 5x4 x 0.3 cm shallow ulcer with irregular borders on the anterior side of the lower-left leg was observed [Figure 1C].
Histopathological findings (Hematoxylin and eosin; x100 and x200 magnifications) showed epidermal acanthosis, dermal fibrosis, and thickening, hemosiderin deposits (blue arrow).
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Histopathological examination of the ulcer margin revealed epidermal acanthosis, dermal fibrosis, and thickening, with hemosiderin deposits [Figure 2].
Fibrin clot at the center of vacutainer (red arrow) (A). Four PRF clots were placed in the entire ulcer area (B). Clinical manifestation of venous leg ulcer before (C), after 4 weeks (D), and after 7 weeks of PRF dressing (E).
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Fibrin clots that appeared in the center of the vacutainer (in between acellular plasma and the red blood cells) after 15 minutes were applied to the ulcer [Figure 3A-C]. The mean reduction area of the ulcer was 43.75% after 2 weeks, 70% after 4 weeks [Figure 3D], and after 7 weeks 99.9% of the ulcer had closed [Figure 3E].