Abstract
Cutaneuos involvement with ulcers occurs in 10% of patients with cryoglobulinemia. Ulcers of the lower limbs are often painful and compromise the quality of life. A careful evaluation of ulcers is therefore mandatory, as is the exclusion of pre-existing arterial disease. Treatment consists of antibiotic swabs, careful cleaning, and appropriate dressing. The best approach is to treat the cryoglobulinemia, but in non-responders colchicine or the low antigen content diet can be useful, both therapeutically and in preventing ulcer formation. Approaches with neuroelectrical stimulation are currently being investigated.
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References
Invernizzi F, Pietrogrande M, Sagramoso B (1995) The cryoglobulinemic syndrome. Clin Exp Rheumatol 13(s13):123–128
Auzerie V, Chiali A, Bussel A et al (2003) Leg ulcers associated with cryoglobulinemia: clinical study of 15 patients and response to treatment. Arch Dermatol 139:391–393
Pietrogrande M, Meroni M (2006) Dysautonomy in the cryoglobulinemic neuropathy: results of a pilot, case-control study. Ann Rheum Dis 65(II):377
Gardner SE, Frantz RA, Doebbeling BN (2001) The validity of clinical signs and symptoms used to identify localized chronic wound infection. Wound Repair Regen 9:178–186
Sibbald RG, Orsted HL, Coutts PM, Keast DH (2006) Best practice recommendations for preparing the wound bed: update. Wound Care Canada 4:15–29
Ferri C, Gremignai G, Bombardieri S et al (1986) Plasma-exchange in mixed cryoglobulinemia. Effects on renal, liver and neurological involvement. Ric Clin Lab 16(2):403–411
Pietrogrande M, Trolese L, Vozzo N, Invernizzi F (2001) Treatment with plasma-exchange and intravenous immunoglobulin for severe cryoglobulinemic syndrome alpha-interferon unresponsive. Reumatismo 53:35–40
Mazzaro C, Pozzato G, Moretti M et al (1994) Long-term effects of alpha-interferon therapy for type II mixed cryoglobulinemia. Haematologica 79:342–349, [published erratum appears in Haematologica 1994 Sep-Oct, 79(5):486]
Sansonno D, De Re V, Lauletta G et al (2003) Monoclonal antibody treatment of mixed cryoglobulinemia resistant to interferon alpha with an anti-CD20. Blood 101:3818–3826
Ferri C, Pietrogrande M, Cecchetti R et al (1989) Low-antigen-content diet in the treatment of patients with mixed cryoglobulinemia. Am J Med 87:519–524
Pioltelli P, Maldifassi P, Vacca A et al (1995) GISC protocol experience in the treatment of essential mixed cryoglobulinaemia. Clin Exp Rheumatol 13(S13):S187–S190
Invernizzi F, Monti G (1993) Colchicine and mixed cryoglobulinemia. Arthritis Rheum 36:722–723
Pietrogrande M, Meroni M, Fusi A, Amato M (2006) Therapeutical approach to the mild cryoglobulinemic syndrome: results from a retrospective cohort study. Ann Rheum Dis 65(II):70
RNAO (registered nurses’ association of Ontario) (2005) Ostomy Care & Management. http://www.RNAO.org/bestpractices
Pietrogrande M, Meroni M (2006) Treatment of cryoglobulinemia-related neuropathic pain, with FREMS neurostimulation: results of a preliminary study. Ann Rheum Dis 65(II):376
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Pietrogrande, M. (2012). Active or Indolent Cutaneous Ulcers in Cryoglobulinemia: How Should They Be Treated?. In: Dammacco, F. (eds) HCV Infection and Cryoglobulinemia. Springer, Milano. https://doi.org/10.1007/978-88-470-1705-4_42
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DOI: https://doi.org/10.1007/978-88-470-1705-4_42
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