No abstract

Careful preoperative management may allow more cutaneous surgery to be carried out in aged people.

A 79-year-old woman with skin ulcers caused by disseminated intravascular coagulation (DIC) therapy is reported. The patient had been treated by injection of drugs, including gabexate mesilate, into the right great saphenous vein. The maximum concentration of gabexate mesilate was calculated as 0.893%. Although the drugs did not extravasate, purpura initially appeared around the affected vein, followed by brown pigmentation with infiltration and ulcers with widely necrotic tissue from the middle portion of her thigh to the malleolus along her right great saphenous vein. As the ulcer showed no tendency to heal for more than 3 months, surgical debridement and skin grafts were performed.

We report an 81-year-old male with long lasting psoriasis with exacerbation who showed remission of skin lesions after cholecystectomy. He consulted our clinic for impetiginous skin lesions and was treated with oral antibiotics without improvement. Several days later, he developed right hypochondralgia and was diagnosed with acute cholecystitis with gallstones. After cholecystectomy, the skin lesions significantly improved and disappeared within three weeks. Laboratory examination data indicated that acute inflammatory parameters normalized simultaneously. Although the role of focal infection in psoriasis is obscure, our case emphasizes the importance of focal infection in the pathogenesis of unstable psoriasis.

Progressive systemic sclerosis (PSS) sine scleroderma is well known as a special form of scleroderma. Because of its rarity, its pathogenesis has not yet been elucidated. We experienced a 33-year-old man who developed PSS sine scleroderma while working with epoxy resin polymerization. He had short white frenulum linguae, diffuse hyperpigmentation and facial telangiectasia, positive antinuclear antibody, and pulmonary dysfunction, but not acrosclerosis or sclerodactylia. Modest dermal collagen proliferation in the forearm skin confirmed PSS sine scleroderma. Epoxy resin polymerizer appears to be a potent causative agent for PSS sine scleroderma as well as for generalized morphea-like PSS.