Difference between revisions of "Pressure ulcer"
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SKIN LESION ("DECUBITUS ULCER"), EXCISION: | SKIN LESION ("DECUBITUS ULCER"), EXCISION: | ||
- ULCERATED SKIN WITH | - ULCERATED SKIN WITH ACANTHOSIS, HYPERKERATOSIS, AND CHRONIC ACTIVE INFLAMMATION -- CONSISTENT WITH A PRESSURE ULCER. | ||
- NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR MALIGNANCY. | ||
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SKIN LESION ("DECUBITUS ULCER"), EXCISION: | SKIN LESION ("DECUBITUS ULCER"), EXCISION: | ||
- SKIN | - ULCERATED SKIN WITH PSEUDOEPITHELIOMATOUS HYPERPLASIA AND CHRONIC ACTIVE INFLAMMATION -- CONSISTENT WITH A PRESSURE ULCER. | ||
- NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR MALIGNANCY. | ||
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Revision as of 19:27, 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.
- Epidermal thickening adjacent to ulcer - pseudoepitheliomatous hyperplasia.[4]
- 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.[5]
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SKIN LESION ("DECUBITUS ULCER"), EXCISION:
- ULCERATED SKIN WITH ACANTHOSIS, HYPERKERATOSIS, AND CHRONIC ACTIVE INFLAMMATION -- CONSISTENT WITH A PRESSURE ULCER.
- NEGATIVE FOR MALIGNANCY.
SKIN LESION ("DECUBITUS ULCER"), EXCISION:
- ULCERATED SKIN WITH PSEUDOEPITHELIOMATOUS HYPERPLASIA AND CHRONIC ACTIVE INFLAMMATION -- CONSISTENT WITH A 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
- ↑ 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.
- ↑ Zayour, M.; Lazova, R. (Apr 2011). "Pseudoepitheliomatous hyperplasia: a review.". Am J Dermatopathol 33 (2): 112-22; quiz 123-6. doi:10.1097/DAD.0b013e3181fcfb47. PMID 21399447.
- ↑ Simmons, MA.; Edwards, JM.; Nigam, A. (Dec 2000). "Marjolin's ulcer presenting in the neck.". J Laryngol Otol 114 (12): 980-2. PMID 11177375.