EWMA 2013 - Ep524 - MADURA FOOT- as differential diagnosis of the chronic wounds on the foot
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Transcript of EWMA 2013 - Ep524 - MADURA FOOT- as differential diagnosis of the chronic wounds on the foot
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MADURA FOOT- as differential diagnosis of the chronic wounds on the foot
Javorka Delic,
Angiology Department,
Belgrade, Serbia
Spasoje Radovanovic, Dermatology department,
Francistown, Bocwana
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8% CWs localised on the foot
During 2012. years in Angiology Department were 5231 chronic wounds different etiology (retrospective study)
Of them 403 (8%) were localised on the foot, at men in 283 cases
Paralel localisation on the foot et limb were in 52 (12,5%) of all cases
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Etiology of the wounds
Pressure wounds 121 (35%)
Veins wounds 97 (24.5%)
Mixtum art.veins 12 (3%)
Arterial wounds 72 (18%)
Postopetrative 12 ( 3%)
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Etilogy of the wounds
Posttraumatic w. 9 ( 2,3%)
Jatrogenes w. 3 (0,5%)
Diabetic wounds 28 ( 4,5%)
Infective wounds 7 ( 2%)
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Etiology of the wounds
Vasculitis wounds -16 (4%)
Others 3,5%
Paralel wounds on the leg and the foot on 52( 12 ,5%)
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Wounds and ages
There was two group
older - 67 years average ,with pressure,veins and arterial wounds
Yanger- 34.5 years average
with vasculitis, infective, posttraumatic wounds
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Wounds on the leg (paralel exam)
Exam the distribution chronic wounds on the leg
The most frequent wounda was - veins wounds
In 65% off all cases
All wounds other etiology -from 0,5% to 17%
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Madura foot
Madura foot is a cause of the wounds on the foot
Specific and rare differential diagnosis ,presenting clinical with the tumefaction, oedema ,
inflammation ,multiple fistulaes and specific scars and anatomic
derformation of the foot .
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Etiology of Madura foot
The disease is decribed, first time Gill , 1842, in Madura, endemic area in India
Etiologically can be Eumycetoma, is evoced by pathogen fungi or Actinomycetoma, and infected by bacteries ( Actinomycetom) on place on the skin thrauma.
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Diagnosis
The diagnosis is determined by :
Clinical signs ; chronic wounds, many cicatrix , swelling and inflammation on the foot
Microbiological exam: Colored “Grains” in exudate-the groups of the causes;
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Diagnosis
Hystological exam – Gram positive finding of gram negative grannulas, with eosinophilic deposits about them (Splendore-Hoeppli reaction);
Rendgen exam of the bones- disturbes of the bones, cavities fulfilled by groups of causes and thinned of bone mass.
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The treatment
The treatment is consisted of by antibiotics, antimycotics and coricosteroides, five weeks ,more repeated sessions and very often in Africa
by operation (amputation).
The wounds were chronic , more months or often, more years.
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Differential diagnosis
Madura foot is infective, non –vascular chronic wounds , in endemic areas and could be one differential diagnosis of CWs on the foot at patients with more small wounds, mycosis of the skin, osteomyelitis, vasculitis, lymphoedema , immunodefitienty and malnutrition.
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Conclusion
Chronic wounds on foot presenting 8% of all CWS on the legs, which were most frequentlly arterial, pressure ,postthraumatic and mixtum wounds.
Madura foot could be in differential diagnosis of the CWs localised on the foot
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Greeting from Bocwana !
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Greeting from Belgrade !
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Thank you!
Prim Dr Javorka Delic
President of Serbian Wound Healing Society