PMC5312191_01
Right lower limb: aspect before treatment. Three deep ulcers on the
lateral aspect and an ulcer in the medial region of the limb reaching
the subcutaneous tissue, with violaceous regular and undermined
edges
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We also observed two other ulcerated lesions on the lateral side of the RLL and an ulcer on the medial side of the RLL with similar characteristics (Figure 1).
Left lower limb: aspect before treatment. On the left, deep ulcer with
violaceous irregular and macerated edges in left medial malleolus
region, with smaller adjacent ulceration. On the right, ulcer on the
anteromedial aspect of the limb. We also observed atrophic scars caused
by previous ulcers.
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A total of seven ulcers were observed (Figure 2).
Histopathology. Ulcerated area with granulation tissue, recent
hemorrhage, perivascular mononuclear inflammatory infiltrate and
fibrosis (Hematoxylin & eosin x40)
abd-92-01-0114-gf03.jpg
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Histopathological study of a lesion revealed unspecific, ulcerated, and chronic inflammation process (Figures 3 and 4).
Histopathology. Histological detail showing inflammatory infiltrate
composed of lymphocytes arranged around vessels (Hematoxylin & eosin
x100)
abd-92-01-0114-gf04.jpg
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Histopathological study of a lesion revealed unspecific, ulcerated, and chronic inflammation process (Figures 3 and 4).
One month after the initiation of treatment. Healing ulcers on the right
(A) and left (B) lower limbs. Re-epithelialization occurs from the edges
of the lesion
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The patient returned a month after discharge showing healing process in the ulcers (Figure 5).
Three months after initiation of treatment. Complete healing of ulcers on
the lateral aspect of the right lower limb
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At the time, we reduced the prednisone dose to 20 mg/daily and kept emollient topical care (Figure 6).