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Note: This page contains sample records for the topic non-healing painful ulcers from
Science.gov.
While these samples are representative of the content of Science.gov,
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Last update: August 15, 2014.
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1
Non-healing diabetic ulcer treated by biobeam 660.
PubMed

A case of 75-year-old male patient with a non-healing ulcer over left sole is reported. Patient was
a known diabetic with CCF. The ulcer was not healing for one month with routine treatment. The
patient was given BIOBEAM 660 therapy every alternate days for a month which led to
complete healing of the ulcer without complications. PMID:20948142
Deshpande, B; Gharpuray, M B
1996-01-01
2
Intravenous infusion for the treatment of diabetic and ischaemic non-healing pedal ulcers.
PubMed
Diabetic and ischaemic non-healing pedal ulcers have a tendency for chronicity and increased
chances of infection, which may threaten the viability of the foot. Systemic administration of
therapeutic agents may be insufficient in these cases. We have assessed the role of retrograde
venous perfusion (RVP) for the treatment of nine diabetic and 10 ischaemic non-healing pedal
ulcers. Agents used were soda bicarbonate, heparin, lignocaine, gentamicin and pentoxiphylline.
Five of nine diabetic non-healing ulcers showed complete healing and the remaining four
improved. The complete recovery in the cases of diabetic ulcer occurred in 10-24 days (mean 16
days), while ischaemic ulcers took 10-14 days for complete recovery (mean 13.6 days). There
was a reduction of rest pain in all 10 patients with ischaemic disease; five patients showed
complete healing of ulcers, and the other five improved significantly. In two patients, pregangrene changes were reversed. RVP is a useful adjunct to conservative or surgical treatment of
non-healing pedal ulcers. Its main impact was in improving ischaemia and promoting healing.
PMID:15752282
Agarwal, P; Agrawal, P K; Sharma, D; Baghel, K D
2005-03-01
3
Heterotopic calcification in burn scars and non-healing ulcers.
PubMed
Heterotopic calcification (HC) is abnormal deposition of calcium salts in tissues other than bone
and enamel. The heterotopic calcification in the burn patients is commonly found either in
periarticular region or in the muscles, but the occurrence of heterotopic calcification of the burn
scar itself in the presence of normal serum calcium, phosphate and alkaline phosphatase is not
reported earlier. We present four adult male patients of lower limbs heterotopic calcification in
burn scars with unusual presentation of non-healing ulcers with a latent period of 15-20 years. In
one of the patient it was Marjolin's ulcer although the lesion was away from the calcified area.

Excision of the calcified scars and the release of contracture have cured the non-healing ulcers
and this may prevent re-calcification in future. PMID:12880726
Ebrahim, Mohammed K; Kanjoor, James R; Bang, Rameshwar L
2003-08-01
4
Accidental radiation exposure leading to non-healing ulcers.
PubMed
Two patients with accidental radiation injury presented at the Sir Ganga Ram Hospital. The first
patient, a 41-year-old male, presented with a large necrotic patch on his right gluteal region,
which was debrided. Due to the progressive nature of the injury, he developed further necrosis
and a non-healing ulcer over the right gluteal region, which was further debrided and covered
with a tensor fascia lata flap. Further necrosis over the ischial region was debrided and covered
with a pedicled gracilis muscle flap, following which he again required debridement and flap
cover for the residual area, which then finally healed. The second patient had a history of
radiation exposure followed by a non-healing ulcer on right arm. He was managed by
debridement and flap coverage in a single sitting. These two cases suggest that wide excision,
thorough debridement and coverage with vascularised tissue are effective in treating radiation
ulcers and emphasise that all radiation sources and their management should be strictly
controlled. PMID:23103484
Gambhir, S; Mangal, M; Gupta, A; Shah, A
2012-10-01
5
New insight into non-healing corneal ulcers: iatrogenic crystals
PubMed Central
Aims To characterise and correlate crystalline precipitations implicated in non-healing corneal
ulceration in two patients with a previous history of acanthamoeba keratitis. Materials and
methods Persistence of acanthamoeba and secondary bacterial infection was excluded with
negative corneal scrapes. Confocal microscopy identified crystal-like deposits within the corneal
stroma. To investigate possible precipitating combinations, all concurrent treatments at the time
of presentation were mixed in wells, with observation of precipitate formation. Precipitates were
observed with phase-contrast microscopy, and subsequently characterised via crystallography
techniques and electrospray ionisation mass spectrometry. Results Combinations of
dexamethasone 0.1% minims and chlorhexidine gluconate 0.2% formed an amorphous material
characterised by electrospray ionisation mass spectrometry as an insoluble chlorhexidine salt.

Combinations of chloramphenicol drops and timolol 0.5% formed a crystal identified via X-ray
crystallography as santite (K(B5O6(OH)4).(H2O)2). This is a borate mineral identified in nature,
arising from thermal springs, but never reported in biological tissues. Clinical improvement was
observed following the cessation of the implicated precipitating combinations. Conclusion Our
observations suggest iatrogenic precipitate formation, with a potential deleterious effect upon
healing. The substrates for these precipitates include several frequently prescribed topical
ophthalmic treatments. These findings shed new light on the aetiopathogenesis of non-healing
corneal ulceration, and have broad implications on topical prescribing for this challenging
condition.
Livingstone, I; Stefanowicz, F; Moggach, S; Connolly, J; Ramamurthi, S; Mantry, S; Ramaesh,
K
2013-01-01
6
Management of non-healing leg ulcers in Unani system of medicine.
PubMed
Non-healing leg ulcers are becoming a major public health problem. The high prevalence of leg
ulcer directly affects patients' quality of life because it produces psychological (anxiety,
depression), social and physical (amputation) handicap. Most leg ulcers become unsightly and
they hardly if ever, yield to conventional treatment. Healing of an amputated part may pose a
problem, hence amputation cannot be recommended without extensive pre-operative
investigations. Prevalence is high among the poor, for whom expenses of surgery are not
affordable. Few surgeons try skin graft but unfavourable local condition of the ulcer leads to
rejection and all efforts prove futile. Keeping all these factors in mind, we have tested a Unani
formulation for its ulcer healing properties; early results were surprising and in some cases
unbelievable. PMID:23116214
Zulkifle, Mohd; Ansari, Abdul H; Shakir, Mohd; Kamal, Zahid; Alam, Md Tanwir
2014-08-01
7
Treatment of non-healing ulcers of the lower extremity with free muscle flaps. Case reports.
PubMed
The surgical management of ulcers in the lower extremity is traditionally conservative, and
includes debridement and split thickness skin grafting. In the most intractable cases, however,
this management is often not enough. In this report of three patients with non-healing ulcers of
the lower extremity successfully treated with free muscle flaps, we advocate a more active

surgical approach to the treatment of such conditions. This is also appropriate in patients for
whom a microsurgical approach might not be considered because of advanced age, peripheral
arterio-occlusive disease, or the presence of other risk factors. PMID:9556825
Arnljots, B; Sderstrm, T; Svensson, H
1998-03-01
8
Primary Non-Hodgkin's Lymphoma of Penis Masquerading as a Non-Healing Ulcer in the Penile
Shaft.
PubMed
Primary malignant lymphoma of the male external genitalia is extremely rare and it is even rarer
in the penis. Because of its rarity, the possibility of delay in diagnosis and mismanagement is
always there. It can present as a nodule, non-healing ulcer, stricture urethra or periurethral
abscess. We report a case presenting first a nodule and later on as a non-healing ulcer which was
diagnosed by corporal biopsy and managed successfully with chemotherapy. PMID:24282797
Karki, Kushal; Mohsin, Rehan; Mubarak, Muhammed; Hashmi, Altaf
2013-07-01
9
Primary Non-Hodgkin's Lymphoma of Penis Masquerading as a Non-Healing Ulcer in the Penile
Shaft
PubMed Central
Primary malignant lymphoma of the male external genitalia is extremely rare and it is even rarer
in the penis. Because of its rarity, the possibility of delay in diagnosis and mismanagement is
always there. It can present as a nodule, non-healing ulcer, stricture urethra or periurethral
abscess. We report a case presenting first a nodule and later on as a non-healing ulcer which was
diagnosed by corporal biopsy and managed successfully with chemotherapy.
Karki, Kushal; Mohsin, Rehan; Mubarak, Muhammed; Hashmi, Altaf
2013-01-01
10
Radiation processed amniotic membranes in the treatment of non-healing ulcers of different
etiologies.

PubMed
The amniotic membranes were collected from the placentae of selected and screened donors.
Processing was done by washing the fresh amniotic membrane successively in sterile saline,
0.05% sodium hypochlorite solution and sterile distilled water until it was completely cleared of
blood particles. The membranes were sterilized by gamma irradiation at 25 kGy. The processed
amniotic membranes were applied to 50 open wounds comprising of 42 full thickness defects
and eight partial thickness defects. These included leprotic, diabetic, traumatic, gravitational
ulcers and superficial burn in the form of scald and corrosive burn. The radiation processed
amniotic membranes favoured healing of unresponsive and non-healing ulcers of different
etiologies. Ulcers with duration of minimum 3 weeks to maximum 12 months were found to heal
in 2-6 weeks by the application of amniotic membranes. PMID:15241010
Singh, Rita; Chouhan, U S; Purohit, Sumita; Gupta, Pallavi; Kumar, Pawan; Kumar, Ashok;
Chacharkar, M P; Kachhawa, Dilip; Ghiya, B C
2004-01-01
11
A non-healing corneal ulcer as the presenting feature of type 1 diabetes mellitus: a case report
PubMed Central
Introduction Diabetic keratopathy is a rare complication of diabetes mellitus. This case illustrates
the importance of checking blood sugar levels of patients with non-healing corneal ulcers to rule
out the possibility of undiagnosed diabetes mellitus. Case presentation We report the unusual
case of a 24-year-old southeast Asian woman who presented with a sterile corneal ulcer to our
hospital and later was found to be diabetic after a prolonged hospital stay. Despite all efforts, the
corneal ulcer had failed to heal until treatment for previously undiagnosed diabetes was started.
The sterile corneal ulcer began to heal once blood sugar levels began to normalize. Conclusions
Diabetic keratopathy is a rare complication of diabetes mellitus and needs to be considered as a
diagnosis in younger patients with non-healing sterile corneal ulcers. Blood sugar levels should
be checked in these cases for undiagnosed diabetes mellitus.
2011-01-01
12
Shewanelia putrefaciens: a rare microbial agent associated with a non-healing ulcer in a leprosy
patient.
PubMed
Female aged 55 years presented with signs and symptoms of borderline lepromatous leprosy and
presence of a non-healing ulcer and multiple haemorrhagic blisters over dorsum of both feet.

Discharge from the various lesions was subjected to microbiological examination and an unusual
organism Shewanella purtefaciens was isolated which was sensitive to most routine antibiotics.
Patient responded well to cephadroxil therapy with uneventful and complete healing of ulcer and
blisters. PMID:21434598
Bhalerao, D S; Kinikar, A G; Roushani, S B; Franklin, V X
2010-01-01
13
Non-healing Scalp Ulcer Accompanying Chronic Arsenicosis: A Case Report
PubMed Central
Arsenic, an environmental toxin, significantly contributes to the development of several health
problems. Epidemiological studies done across the globe have reported that a prolonged arsenic
exposure has been associated with characteristic skin lesions, neuropathy and an increased risk of
skin, lung, liver (angiosarcoma), bladder, kidney and colon cancers. In present study, we are
reporting a case of a 60-year-old male, who presented with a large (5cm x 4cm) painless ulcer in
fronto-parietal area of scalp, with occasional oozing of blood. X-ray of skull (AP and lateral
view) revealed granular well-outlined osteolytic lesions in right fronto-parietal skull vault, which
raised a suspicion of malignancy. An incisional biopsy was taken and histopathology revealed no
evidence of malignancy. A benign, non-healing skin ulcer is rarely seen in a setting of chronic
arsenicosis. His skin examination showed characteristic fine freckles of spotted pigmentary
changes i.e. classic rain-drop pigmentations which were present all over the body, particularly on
trunk, palms and soles. Arsenic levels seen in hair and nail of the patient were 1.23
micrograms/gram and 3.26 micrograms/gram respectively, which were in accordance with WHO
suggested diagnostic criteria of chronic arsenicosis.
Banerjee, Indranil; Sen, Sukanta; Tripathi, Santanu Kumar
2014-01-01
14
Early diagnosis is vital in the management of squamous cell carcinomas associated with chronic
non healing ulcers: a case series and review of the literature.
PubMed
The association between chronic ulcers and squamous cell carcinomas (SCCs) is well
established. Their clinical presentations, however, are varied, ranging from innocously appearing
lesions to overtly exophytic growths. We present a series of cases with heterogeneous clinical
presentations and different treatment outcomes. Case series - patient 1 was a 69-year-old man
with an 18-month history of static non healing venous leg ulcer, but no sinister features, biopsy

was performed to rule out Marjolin's transformation, histology revealed SCC and treatment was
simple excision and skin grafting; patient 2 was a 73-year-old lady with an 18-month history of
non healing ulcer (innocuous appearance) over distal interphalangeal joint of index finger,
histology revealed SCC with deeper extension and treatment was amputation of distal half of
finger; patient 3 was a 73-year-old lady with a 12-month history of non healing fungating leg
ulcer with irregular borders and everted edges, histology revealed SCC (tumour eroding tibia and
distant metastasis) and treatment was above-knee amputation, radiotherapy and palliation. Whilst
SCC is amenable to simple excision in the early stages, delay in diagnosis could result in loss of
the affected digit or limb; an SCC which has metastasised is also life threatening. Therefore, a
low threshold to biopsy static non healing ulcers or ulcers in unusual sites should be adopted
even in those not manifesting any evidence of malignancy. PMID:16722875
Enoch, Stuart; Miller, David R; Price, Patricia E; Harding, Keith G
2004-09-01
15
Prevalence of osteomyelitis in non-healing diabetic foot ulcers: usefulness of radiologic and
scintigraphic findings.
PubMed
The study was conducted in order to assess the prevalence of osteomyelitis and the predictive
value of radiographic (xR) and combined Tc 99-bone and leukocyte scanning (CS) findings in
diabetic foot ulcers that met criteria for hospital admission (FUH). Out of 150 episodes of
ulceration managed in an outpatient basis, 33 (in 28 NIDDM patients) requiring admission were
evaluated. In all cases plain xR and CS were carried out. Seventeen episodes (51.5%) had a good
outcome (healed or improving, at the time of the last follow up). Osteomyelitis was found in 21
episodes and 14 (66.6%) of them required an amputation. In 13 cases where xR showed
characteristic radiologic changes of osteomyelitis (11 of them had a positive CS) 11 (84.6%)
underwent an amputation. However, when osteomyelitis was diagnosed only by a positive CS,
only 3/8 (37.5%) required a toe amputation. Severe peripheral vasculopathy was present in 44%
of cases who required amputation and only in 17.6% of those who did not. We conclude that in
FU underlying osteomyelitis is frequent and associated to a higher amputation rate than when no
bone infection is identified (66.6 vs 17%), even when corrected for vascular status (OR 11, CI
95% 1.65-74.2), with a worse outcome when xR changes are already present. PMID:9483376
Balsells, M; Viad, J; Milln, M; Garca, J R; Garca-Pascual, L; del Pozo, C; Anglada, J
1997-11-01
16
Pressure ulcer related pain in community populations: a prevalence survey

PubMed Central
Background Pressure ulcers are costly to the healthcare provider and can have a major impact on
patients quality of life. One of the most distressing symptoms reported is pain. There is very
little published data on the prevalence and details of pain experienced by patients with pressure
ulcers, particularly in community populations. The study was conducted in two community NHS
sites in the North of England. Methods The aim was to estimate the prevalence of pressure area
related pain within a community population. We also explored the type and severity of the pain
and its association with pressure ulcer classification. A cross-sectional survey was performed of
community nurses caseloads to identify adult patients with pressure ulcers and associated pain.
Consenting patients then had a full pain assessment and verification of pressure ulcer grade.
Results A total of 287 patients were identified with pressure ulcers (0.51 per 1000 adult
population). Of the 176 patients who were asked, 133 (75.6%) reported pain. 37 patients
consented to a detailed pain assessment. Painful pressure ulcers of all grades and on nearly all
body sites were identified. Pain intensity was not related to number or severity of pressure ulcer.
Both inflammatory and neuropathic pain were reported at all body sites however the proportion
of neuropathic pain was greater in pressure ulcers on lower limbs. Conclusions This study has
identified the extent and type of pain suffered by community patients with pressure ulcers and
indicates the need for systematic and regular pain assessment and treatment.
2014-01-01
17
Multiple oral ulcers leading to diagnosis of pulmonary tuberculosis
PubMed Central
We report a 47 year old man who presented with painful non-healing tongue ulcers of 3 months
duration. Examination revealed an additional buccal ulcer that he was unaware of.
Histopathology of the ulcers showed caseation necrosis. Following this report, chest radiography
and sputum microscopy performed revealed pulmonary tuberculosis. From this case-study, one
should be aware of coexisting pulmonary tuberculosis in patients with chronic non-healing oral
ulcers, both for diagnosis as well as prevention of transmission through respiratory droplets.
Nagaraj, Vezhavendhan; Sashykumar, Shanthi; Viswanathan, Stalin; Kumar, Sathish
2013-01-01
18
Painful skin ulcers in a hemodialysis patient.
PubMed

Calciphylaxis, also referred to as calcific uremic arteriolopathy, is a relatively rare but well
described syndrome that occurs most commonly in patients with late stage CKD. It is
characterized by very painful placques or subcutaneous nodules and violaceous, mottled skin
lesions that may progress to nonhealing ulcers, tissue necrosis, and gangrene with a 1-year
mortality rate >50%. The pathogenesis of calciphylaxis is poorly understood. Risk factors
include female sex, obesity, hyperphosphatemia, hypercalcemia, hyperparathyroidism, longer
dialysis vintage, hypercoagulable states, and use of calcium-containing phosphate binders and
warfarin. Treatment strategies for calciphylaxis are limited by inadequate understanding of its
pathophysiology. Therapy is generally focused on correcting disturbances of calcium,
phosphorus, and parathyroid hormone metabolism. Additional therapy focuses on decreasing
inflammation and on dissolution of tissue calcium deposits with sodium thiosulfate and/or
bisphosphonates. Successful treatment generally results in improvement of pain and healing of
the lesions within 2-4 weeks, but the disorder generally takes many months to completely
resolve. PMID:24202137
Sprague, Stuart M
2014-01-01
19
NeutroPhase in chronic non-healing wounds
PubMed Central
Chronic non-healing wounds, such as venous stasis ulcers, diabetic ulcers, and pressure ulcers
are serious unmet medical needs that affect a patients morbidity and mortality. Common
pathogens observed in chronic non-healing wounds are Staphylococcus including MRSA,
Pseudomonas, Enterobacter, Stenotrophomonas, and Serratia spp. Topical and systemically
administered antibiotics do not adequately decrease the level of bacteria or the associated biofilm
in chronic granulating wounds and the use of sub-lethal concentrations of antibiotics can lead to
resistant phenotypes. Furthermore, topical antiseptics may not be fully effective and can actually
impede wound healing. We show 5 representative examples from our more than 30 clinical case
studies using NeutroPhase as an irrigation solution with chronic non-healing wounds with and
without the technique of negative pressure wound therapy (NPWT). NeutroPhase is pure
0.01% hypochlorous acid (i.e. >97% relative molar distribution of active chlorine species as
HOCl) in a 0.9% saline solution at pH 4-5 and is stored in glass containers. NovaBay has three
FDA cleared 510(k)s. Patients showed a profound improvement and marked accelerated rates of
wound healing using NeutroPhase with and without NPWT. NeutroPhase was non-toxic to
living tissues.
Crew, John; Varilla, Randell; Rocas, Thomas Allandale; Debabov, Dmitri; Wang, Lu; Najafi,
Azar; Rani, Suriani Abdul; Najafi, Ramin (Ron); Anderson, Mark
2012-01-01

20
Painful ulcers in a 5-year-old girl
Microsoft Academic Search
A 5-year-old girl was admitted to our clinic with several painful ulcers spreading from the right
elbow to the armpit. The\\u000a right axillary lymph node was palpable. She was previously
treated in another service with oral amoxicillin for 10 days due\\u000a to a diagnosis of
impetigo. There was no resolution of the lesion after the treatment, so she looked for another
Maria do Socorro Costa da Silva; Ellem Ramos Ferreira; Leonardo Rodrigues Campos; Mrcio
Tadeu Vieira Brito; Patricia Ferreira; Rodrigo Silva Grilo
2011-01-01
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