Inflammatory and vaso-occlusive ulcers: Part II - Management

Alex Hines; Shannon Kody; Hadir Shakshouk; Nicole Fett; Afsaneh Alavi; Alex Ortega-Loayza

doi:10.1016/j.jaad.2023.12.077

Inflammatory and vaso-occlusive ulcers: Part II - Management

J Am Acad Dermatol. 2024 Mar 1:S0190-9622(24)00424-9. doi: 10.1016/j.jaad.2023.12.077. Online ahead of print.

Authors

Alex Hines¹, Shannon Kody², Hadir Shakshouk³, Nicole Fett², Afsaneh Alavi¹, Alex Ortega-Loayza⁴

Affiliations

¹ Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
² Department of Dermatology, Oregon Health & Science University, Portland, Oregon.
³ Department of Dermatology, Oregon Health & Science University, Portland, Oregon; Department of Dermatology, Andrology and Venerology, Alexandria University, Alexandria, Egypt.
⁴ Department of Dermatology, Oregon Health & Science University, Portland, Oregon. Electronic address: ortegalo@ohsu.edu.

PMID: 38432460
DOI: 10.1016/j.jaad.2023.12.077

Abstract

In the second part of this CME, we present an approach for the management of inflammatory and vaso-occlusive ulcers and highlight the need for further research in this field. The three overarching principles for management are etiology-specific treatment, ulcer care, and consideration of patient comorbidities and risk factors for poor healing. Both etiology-specific treatment and management of patient comorbidities and risk factors often require collaboration with providers from other specialties. Ulcer care is governed by TIME, or tissue debridement, infection control, management of moisture imbalance and epithelial edge advancement. As wound healing is a dynamic process, management should be adapted to changes in the status of the ulcer.

Keywords: anti-phospholipid syndrome; autoimmune; inflammatory ulcers; livedoid vasculopathy; pyoderma gangrenosum; ulcer care; vasculitis; vasculopathies; vaso-occlusive ulcers.

Publication types

Review