Treatment of multiple refractory ankle ulcerations in thromboangiitis obliterans: A case report

Medicine
Zheng-Hao HuangChun-Chi Lu

Abstract

Thromboangiitis obliterans (TAOs, or Buerger's disease) present as a non-atherosclerotic segmental occlusive vasculitis within medium- and small-sized blood vessels. TAO frequently occurs in young adults and is associated with cigarette smoking. At present, there are no accurately defined treatments for TAO. A 34-year-old Asian woman with a 20-year history of heavy cigarette smoking and recurrent, small, and self-limited lower limb ulcerations since adolescence, presented with persisting unhealed ulcerations on both ankles for 6 months. Her wound healing response was poor following the 2-month administration of colchicine, prednisolone, hydroxychloroquine, and mycophenolic acid. The patient was diagnosed with TAO with hyperimmunoglobulin E and refractory ulcerations on her ankles. The patient received monthly omalizumab (300 mg) and previous medications for 2 months and shifted to omalizumab and colchicine without mycophenolic acid and hydroxychloroquine because of onychomadesis, which was considered to be a possible adverse drug reaction. The wounds healed almost completely. The administration of omalizumab and colchicine will be continued until they the wounds are fully healed. Mycophenolic acid has a limited function in TAO ...Continue Reading

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