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June 1991

Cultured Allografts as an Adjunct to the Medical Treatment of Problematic Leg Ulcers

Author Affiliations

University School of Medicine; Brown University Program in Medicine, Providence, RI

Arch Dermatol. 1991;127(6):799-801. doi:10.1001/archderm.1991.01680050041003


Case 1.—  A 33-year-old black woman had a 15-year history of multiple recalcitrant skin ulcers on the lower extremities. The skin biopsy specimen showed typical features of sarcoidosis. Also, pulmonary involvement with lethargy, dyspnea on exertion, bilateral hilar lymphadenopathy, and diffuse interstitial shadowing on chest roentgenogram were present.Her leg ulcers were initially treated with hydroxychloroquine, with temporary healing. Subsequent recurrences of the ulcers were unresponsive to hydroxychloroquine therapy, and systemic corticosteroids were prescribed. The ulcers did not respond either to therapy with intralesional triamcinolone or to increasing doses of oral prednisone up to 60 mg/d. Her steroid therapy was complicated by hypertension and insulin-dependent diabetes. Because of recurring ulcerations on her legs, hydroxychloroquine (800 mg/d) was added to the patient's steroid regimen. The ulcers healed temporarily for 2 months but recurred when the antimalarial dosage was reduced to 400 mg/d.A trial of topical cromolyn sodium

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