Vasculitis, ulcer and thrombophlebitis: what shall we do?

Good morning, my mum has been diagnosed with ulcer vasculitis and thrombophlebitis. After the therapy with cortisone, blood vessels appeared to have improved in constriction.

I have been taking 30mg of Deltacortene each day for almost one month. The problem is that the wound is ulcerous because it hurts a lot.

Some inadine dressings have been applied. In the unfortunate case of a direct contact with water, it seems like she had touched acid in terms of burning and pain.

What can we do and how can we treat this symptomatology?

Thank you for your attention, Renato

One comment on “Vasculitis, ulcer and thrombophlebitis: what shall we do?

  1. Klarida Hoxha on

    Dear Renato,
    thank you for contacting us.
    I’m so sorry for your mum. Vasculitis are complicated ulcers and they are categorized as non-healing wounds.

    They are caused by an inflammation of the skin blood vessels usually with immunological genesis. The immune system recognizes the body cells as “enemies” and attacks them, thus causing inflammation and vessels necrosis. They can occur in patients with rheumatic diseases; they are absolutely numerous and of different etiology.

    The main concept is that wound is a disease symptom, not a disease, so healing the symptom doesn’t solve the problem but it’s necessary to understand which disease has caused it.
    In your request I don’t understand where the problem comes from.

    What your mum needs is a multidisciplinary and multiprofessional approach to treat the ulcer cause.
    To make a diagnosis of vasculitis I suppose you had a biopsy and specific blood exams. This helps you identify also the right therapy to improve the state of health from a systemic point of view.
    From a local point of view it’s necessary that the mum is followed by a nurse specialized in non-healing wound care. Vasculitis are really hard to treat and the pain is their main feature.

    In addition to pain-specific therapies (it’s better to rely on an antalgic specialist), it’s possible to act locally through unaesthetic creams that have both a temporary action (in soothing background pain) and a procedural action (in changing the medication).

    At our Centre we use Ortodermina (Lidocaine hydrochloride) together with non-adherent and non-aggressive medications, in order to facilitate its removal.

    Vasculitis is an evolutive lesion, so it has its timing that needs to be respected. It’s good to know and inform the patient that there are several phases to go through:

    • Active phase: the lesion gets worse and wider, the perilesional skin is really suffering. There are also necrosis areas or fibrin, abundant exudation and marked inflammatory phenomena. For instance, in order to remove the necrotic tissue hydrogel might be used rather than other types of debridement that would cause pain.
    • State phase: a neat reduction of the inflammatory factors, the wounds borders are similar to a burn, the lesion doesn’t expand and the necrotic part is already removed.
    • Remission phase: the lesion is granulating, the perilesional skin is pink and the exudation is contained. The analgesic therapy is in reduction and the medications don’t present great difficulties.

    At the Hyperbaric Centre we evaluate all these characteristics thanks to the work of our medical nurse team specialized in non-healing wounds.

    Best regards,
    Klarida Hoxha

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