Phenytoin-induced lymphocytic chemotaxis, angiogenesis and accelerated healing of decubitus ulcer in a patient with stroke.
We studied the effect of topically applied phenytoin on the healing of a decubitus ulcer in the sacral region of an immobile patient with stroke. Another similar, but smaller, ulcer was treated with conventional treatment only and served as a control. The ulcers were measured once a week and biopsies were taken from the margins before, 1 week and 2 weeks after commencing treatment with phenytoin. Clinically, phenytoin substantially accelerated the rate of healing. Microscopic examination of the biopsies showed increased lymphocytic infiltration of the phenytoin-treated lesion. Anti-CD31 immunohistochemistry revealed dense CD31+ lymphocytic infiltration and increased angiogenesis only in the phenytoin-treated lesion. Our findings suggest that phenytoin enhances wound healing by stimulating lymphocytic chemotaxis and up-regulation of angiogenesis.
Pitiakoudis
M
M
Second Department of Surgery, Medical School, Democritus University of Thrace, Alexandoupolis, Greece.
Giatromanolaki
A
A
Iliopoulos
I
I
Tsaroucha
A K
AK
Simopoulos
C
C
Piperidou
C
C
D002634:Chemotaxis, Leukocyte / Q000187:drug effects*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic / Q000187:drug effects*; D010672:Phenytoin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D003668:Pressure Ulcer / Q000503:physiopathology / Q000628:therapy*; D014945:Wound Healing / Q000187:drug effects*
D010672:Phenytoin