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Chronic Ulcerations in the Upper and Lower Extremities
Glenn L. Zellerman, MD;
Michael T. S. Lin, BA;
Ida Orengo, MD;
Ted Rosen, MD
Baylor College of Medicine, Houston, Tex
Arch Dermatol. 1998;134:1019-1024.
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REPORT OF A CASE
A 44-year-old Hispanic man presented with a 25-year history of chronic nonhealing ulcers in the upper and lower extremities and in both hands. The patient's ulcerations continued to worsen over time, despite the use of antibiotics and good local wound care. He then developed lower-extremity gangrene and generalized leg pain with walking, which eventually necessitated several surgical approaches, including amputation below the knee on the right leg and above the knee on the left leg and a sympathectomy on the right leg.
The episodes of painful hand ulcerations, which he described as feeling like fire, progressed over the 4 months before he presented. He also complained of aching hand pain, hand cramping, and digital numbness with tingling; a cold environment intensified these symptoms and turned the color of his hands to a pale white. His . . . [Full Text of this Article]
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