Management guideline for Werner syndrome 2020. 6. Skin ulcers associated with Werner syndrome: Prevention and non‐surgical and surgical treatment

Abstract

Aim To provide guidelines on the diagnosis, treatment, and prevention of skin ulcers in Werner syndrome. Methods This article was based on literature from 1996, when WRN was identified as a gene responsible for Werner syndrome, and we evaluated several authentic clinical cases of genetically diagnosed patients. There were 63 patients with Werner syndrome in the Japanese reports retrieved from Medical Online between January 1996 and December 2017. There were 56 patients with Werner syndrome in English reports written by Japanese authors and retrieved from PubMed during the same period. Results Records on skin ulcers were found in 27 (43%) out of 63 patients and 22 (40%) out of 56 patients from the Japanese and English reports, respectively. The reported ulcers were often located at the distal one‐third of the lower legs. There were 8 patients with callosities in the foot in the Japanese reports and 9 patients in the English reports. A skin ulcer in Werner syndrome is generally intractable. Weight‐bearing ulcers or callosity should be critically assessed in surgical procedures because they have effects on patient pain and gait. By adopting a recently advanced technique to facilitate wound healing, the cases of ulcers that were difficult to treat and those requiring major operations can be closed with minimally invasive surgery. Conclusions Skin ulcers in Werner syndrome are refractory, and they lead to reduced quality of life of patients. A callosity in Werner syndrome is an important therapeutic target for the prevention of ulcers. Geriatr Gerontol Int 2021; 21: 153–159.

Case Report: A novel WRN mutation in Werner syndrome patient with diabetic foot disease and myelodysplastic syndrome

“…Insulin, metformin tablets, and pioglitazone dispersible tablets were used in our patient, and for 18 months of treatment, there were no adverse reactions. The probability of skin ulcers in Werner syndrome was about 40%, and ulcers were often located at the distal one-third of the lower legs (8). Skin ulcers in Werner syndrome patients might be a double effect of the WRN gene abnormality and poor blood glucose control.…”

Atherosclerosis and Cardiovascular Diseases in Progeroid Syndromes

“…If multiple corn/callus and calcification of the Achilles tendon are observed, genetic testing should be conducted to confirm the diagnosis. Please refer to the "Management guideline for Werner syndrome 2020" series for the main strategy to treat each specific symptom [52][53][54][55][56][57][58][59] .…”

Non-Melanoma Skin Cancers and Other Cutaneous Manifestations in Bone Marrow Failure Syndromes and Rare DNA Repair Disorders

“…Development of skin ulcers is a primary source of morbidity for individuals with Werner syndrome. Approximately 40% of individuals with Werner syndrome develop skin ulceration ( 85 ). They most commonly develop at pressure points on the leg, ankle, soles of the feet, and elbows ( 86 ).…”

“…Skin thinning, tightness, and dryness are common signs of premature dermatological aging in Werner syndrome ( 85 ). Patients can be prone to developing calluses, which if not treated, can progress to skin ulcers ( 85 ). Poikiloderma has also been reported in patients with Werner syndrome ( 85 ).…”

“…Patients can be prone to developing calluses, which if not treated, can progress to skin ulcers ( 85 ). Poikiloderma has also been reported in patients with Werner syndrome ( 85 ).…”