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Objectives The aim of the study is to compare proportions of venous leg ulcers healed in patients treated with two different sub-bandage pressure values in relation to age. Methods The study included 102 outpatients with venous leg ulcers, one group with moderate compression pressure of 35-40 mmHg and the second with high pressure>45 mmHg. Each group was divided into two subgroups according to the age (≥65 vs. <65 years). Computerized planimetry was used to measure the size of the ulcers at 6, 12, 18 and 24 weeks. Results Kaplan-Maier analysis showed high pressure leads to higher proportion of healed venous leg ulcers, compared to moderate pressure, in patients aged ≥65 years (57.6% vs. 28%) and in patients <65 years (53.8% vs. 36%) (p < 0.05). Conclusion The study showed that higher compression pressure leads to higher proportions of venous leg ulcers healed, independent of age and could be safely preferred in older patients.

associated with systemic, even lethal manifestations, fi broblast proliferation and accumulation of acid mucopolysaccharides of the hyaluronic acid. Serum IgG class paraproteinemia is always present and it can be detected in all patients after appropriate or repeat testing (1,2,3).A case of an adult male with IgG paraproteinemia, in whom lichenoid papules evolved to scleromyxedema after two years, is reported. L ichen myxedematosus, also known as papular mucinosis, is a primary diff use cutaneous mucinosis. It is a rare cutaneous myxedematous condition characterized by formation of numerous lichenoid papules. Scleromyxedema, or ArndtGottron syndrome, is a rare, confl uent, papular and sclerotic variant of lichen myxedematosus, which is characterized by diff use thickening of the skin that underlies the papules. Th e condition is AbstractLichen myxedematosus, also known as papular mucinosis, is a primary diffuse cutaneous mucinosis. It is a rare cutaneous myxedematous condition characterized by formation of numerous lichenoid papules. Scleromyxedema, also known as Arndt-Gottron syndrome, is a rare, confl uent, papular and sclerotic variant of lichen myxedematosus, characterized by diffuse thickening of the skin underlying the papules. The condition is associated with systemic, even lethal manifestations, fi broblast proliferation and accumulation of acid mucopolysaccharides of the hyaluronic acid. Serum IgG class paraproteinemia is always present and it can be detected in all patients if appropriate or even repeat testing is used. Herein, we present a 67-year-old patient with a 2-year history of skin problems. He had no health problems other than hypertension and diabetes, wich were both diagnosed 15 years before. On examination, the patient exhibited sclerodermoid lesions with diffuse pseudo-sclerodermatous thickening of the exposed skin, microstomia and sclerodactyly-like changes; on the face, there were numerous solid, shiny 2 -4 mm in diameter skin-coloured lichenoid papules, scattered across the forehead, glabellar area, nasolabial folds, perioral region, ear lobes and the neck. Histopathological examination revealed: highly distinctive collagenosis and fi brosis in the middle dermis, increased fi broblasts; collagen bundles with irregular arrangement and fragmentation; alcian blue-positive deposits with appearance consistent with acid mucins. Serum protein electrophoresis detected IgG lambda paraproteinemia. The patient was treated with systematic corticosteroids during 9 months with subsequent introduction of methotrexate and showed satisfactory results. The etiology of scleromyxedema remains unknown, since the purifi ed IgG paraprotein itself has no direct effects on fi broblast proliferation. In scleromyxedema, numerous therapeutic modalities are proposed, unfortunatelly with limited effects. In colclusion, we report a case of an adult male with lichenoid papules; after a two-year progression, they evolved into scleromyxedema and exhibited well response to conventional therapy.

According to the results of this research, we can conclude that patients’ sex, age and severity of the clinical form of AA are not in connection with the seasons, while there are certain connections between appendicitis occurrence and atmospheric temperature and pressure.

Introduction: Venous ulcers account for over 80% of chronic wounds in the lower extremities. Venous ulcers lead to a significant decrease in the patients' quality of life. Aim: To compare the effectiveness of two different sub-bandage pressure values on healing and quality of life outcomes. Material and methods:The study included 116 outpatients with venous leg ulcers (VLUs), one group with a moderate compression pressure of 35-40 mm Hg and the second with a high pressure > 45 mm Hg. The Kaplan-Meier curve and log rank test were used to estimate healing by type of compression. Quality of life measures included: Quality of Life Index (QL), Numeric Pain Rating Scale (NPRS) and Geriatric Depression Scale (GDS). Patients were followed for 24 weeks. Results: Kaplan-Maier analysis showed that a high pressure leads to a higher proportion of healed VLUs, compared to the moderate pressure (p = 0.011). QL, GDS and NPRS at the beginning were equalized between the groups. In patients with a high compression, there was a statistically significant increase in QL (p = 0.005), decrease in GDS (p = 0.040) and NPRS (p = 0.002) during 24 weeks. In patients with moderate compressions there was a statistically significant increase in QL (p = 0.013). Conclusions: Patients who received high pressure, healed faster. When a high pressure was applied, there was a statistically significant increase in QL, decrease in GDS and NPRS compared to the group of patients to whom the moderate pressure was applied.

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