A Different Harlequin Color Change Case

Demirkan, Serkan; Gündüz, Özgür

doi:10.5336/dermato.2017-56994

“…Antiseptikler geniş spektrumlu antimikrobiyal etki ve düşük toksisiteye sahip oldukları ve etkilerine direnç gelişmediği için yara bakım ürünlerinde tercih edilirler. İnfekte yaralar her zaman eksuda ile birliktedir; antimikrobiyal yara örtüleri ile hem eksuda kontrolü hem de hızlı ve sürekli antimikrobiyal etki sağlanabilir (211).…”

Section: Soru 2: Yara Bakım Malzemelerinin öZellikleri Nelerdir?unclassified

Untitled

2024

Klimik Derg

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Surgical management of DF ulcers can be analyzed in five sections: (a) Urgent ulcer intervention; abscess drainage and/or debridement, (b) surgical interventions for vascular pathologies, (c) ulcer closure interventions; reconstruction methods; graft and flap surgery, (d) reconstruction of bone and foot pathologies for ulcer prevention and treatment (Charcot foot deformity, Achilles lengthening, tenotomy, and osteotomies, etc.), (e) minor and major amputations when necessary. 14) Amputation may be a more appropriate choice when infected tissue cannot be completely cleaned with debridement, when the patient is bedridden or has a non-functional extremity, when it is believed that adequate revascularization cannot be achieved by orthopedic and plastic surgical interventions, in cases where reconstruction is nearly impossible, and in dialysis patients. 15) The goal of post-DFI reconstruction is to allow the ankle to reach a neutral position and to make the plantar surface of the foot have a balanced contact with the ground. 16) Selected ulcer care products can be used based on the characteristics of the ulcer to support and accelerate ulcer healing, reduce the risk of complications, ensure patient comfort during treatment, and improve quality of life. 17) DF ulcers often develop due to improper shoe selection during the structural and biomechanical changes, resulting in fluid accumulation and callus formation around bone surfaces. 18) Orthoses, which distribute pressure over the widest possible area, are the most effective means of reducing plantar pressure in the foot. 19) Hyperbaric oxygen therapy is beneficial in addition to revascularization and antibiotic therapy, which are the primary treatments for pathologies causing tissue hypoxia, such as ischemia, infection, and edema. 20) Negative pressure ulcer therapy is an additional adjunct method to conventional techniques, and it can contribute to the healing process with the correct indications. 21) In cases where the infection is under control, active osteomyelitis is absent, topical epidermal growth factor (EGF) can be used for Meggitt-Wagner ulcer classification grade 1-3, and intralesional EGF applications can be used for grade 3-4 in addition to standard treatments. 22) Preventive medical practices in people with diabetes, collaborative efforts of the patients, their families, and the medical team, and regular patient education are necessary to prevent DF ulcer development. In the event of DF ulcer development, interdisciplinary collaboration in moderate/severe infections is essential for early treatment and infection prevention.

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“…Antiseptikler geniş spektrumlu antimikrobiyal etki ve düşük toksisiteye sahip oldukları ve etkilerine direnç gelişmediği için yara bakım ürünlerinde tercih edilirler. İnfekte yaralar her zaman eksuda ile birliktedir; antimikrobiyal yara örtüleri ile hem eksuda kontrolü hem de hızlı ve sürekli antimikrobiyal etki sağlanabilir (211).…”

Section: Soru 2: Yara Bakım Malzemelerinin öZellikleri Nelerdir?unclassified

Diagnosis, Treatment, Prevention, and Rehabilitation of Diabetic Foot Ulcers and Infections: Turkish Consensus Report, 2024

Kadanali,

Saltoglu,

Ak

et al. 2024

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Surgical management of DF ulcers can be analyzed in five sections: (a) Urgent ulcer intervention; abscess drainage and/or debridement, (b) surgical interventions for vascular pathologies, (c) ulcer closure interventions; reconstruction methods; graft and flap surgery, (d) reconstruction of bone and foot pathologies for ulcer prevention and treatment (Charcot foot deformity, Achilles lengthening, tenotomy, and osteotomies, etc.), (e) minor and major amputations when necessary. 14) Amputation may be a more appropriate choice when infected tissue cannot be completely cleaned with debridement, when the patient is bedridden or has a non-functional extremity, when it is believed that adequate revascularization cannot be achieved by orthopedic and plastic surgical interventions, in cases where reconstruction is nearly impossible, and in dialysis patients. 15) The goal of post-DFI reconstruction is to allow the ankle to reach a neutral position and to make the plantar surface of the foot have a balanced contact with the ground. 16) Selected ulcer care products can be used based on the characteristics of the ulcer to support and accelerate ulcer healing, reduce the risk of complications, ensure patient comfort during treatment, and improve quality of life. 17) DF ulcers often develop due to improper shoe selection during the structural and biomechanical changes, resulting in fluid accumulation and callus formation around bone surfaces. 18) Orthoses, which distribute pressure over the widest possible area, are the most effective means of reducing plantar pressure in the foot. 19) Hyperbaric oxygen therapy is beneficial in addition to revascularization and antibiotic therapy, which are the primary treatments for pathologies causing tissue hypoxia, such as ischemia, infection, and edema. 20) Negative pressure ulcer therapy is an additional adjunct method to conventional techniques, and it can contribute to the healing process with the correct indications. 21) In cases where the infection is under control, active osteomyelitis is absent, topical epidermal growth factor (EGF) can be used for Meggitt-Wagner ulcer classification grade 1-3, and intralesional EGF applications can be used for grade 3-4 in addition to standard treatments. 22) Preventive medical practices in people with diabetes, collaborative efforts of the patients, their families, and the medical team, and regular patient education are necessary to prevent DF ulcer development. In the event of DF ulcer development, interdisciplinary collaboration in moderate/severe infections is essential for early treatment and infection prevention.

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“…Cutis marmot, Port wine stain, and nascent hemangioma are all differential diagnoses that may be mistaken for HCC. Prompt identification of HCC is critical since the rapid color change may worry parents and care professionals (2,9,12,52). HCC should not be confused with Harlequin fetus, a genetically determined cutaneous disorder that manifests as very hard, thick skin prone to cracking and splitting, leading to deformation and respiratory restriction.…”

Section: Diagnosismentioning

confidence: 99%

Harlequin Color Change: a brief literature review

Pinel-Guzmán

¹

,

Fernández

²

,

Dubón³

2021

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Introducción: en 1952, Neligan y Strange describieron por primera vez un fenómeno raro, que se produce en el periodo neonatal y se caracteriza por un cambio repentino del color de la piel, con una línea recta que divide la mitad del cuerpo como si hubiera sido "dibujada con un lápiz y una regla" que discurre por la línea media, presentando la mitad del cuerpo eritematoso y la otra pálida. Objetivo: presentar literatura relacionada con el fenómeno del cambio de color arlequín y sus diferentes presentaciones clínicas. Métodos: se llevó a cabo una revisión no sistemática de la literatura disponible utilizando palabras claves como “Harlequin Color Change”, “Harlequin Newborn”, “Harlequin Color Change NOT Syndrome NOT ichthyosis” además de sinónimos, que se combinaron con los conectores “AND” y “OR”, tanto en inglés como en español, en las bases de datos PubMed, ScienceDirect y Google Academics. Resultados: el cambio de color arlequín se caracteriza por un aspecto de la piel dividida en dos zonas de color distinto. Se desconoce su etiología, pero se cree que está causado por inmadurez de la regulación hipotalámica del tono vascular periférico. Afecta aproximadamente 10% de los neonatos sanos. Conclusiones: el cambio de color arlequín es una condición benigna, idiopática y autolimitada que no necesita tratamiento. El médico debe reconocer este fenómeno, que presenta una variedad de patrones de cambio de color. Es esencial informar a los padres de esta afección cutánea benigna y transitoria para evitar pruebas y tratamientos innecesarios. No debe confundirse con la ictiosis arlequín.

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A Different Harlequin Color Change Case

Cited by 3 publications

References 10 publications

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Diagnosis, Treatment, Prevention, and Rehabilitation of Diabetic Foot Ulcers and Infections: Turkish Consensus Report, 2024

Harlequin Color Change: a brief literature review

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