title: Digital gangrene associated with idiopathic hypereosinophilia: treatment with allogeneic cultured dermal substitute (CDS).
abstract: In the present case study, the patient was a 65-year-old man who suddenly developed purpuric and necrotic lesions with severe pain in his fingers and toes. Laboratory investigations revealed marked eosinophilia (77.9%), but there was no evidence to support a diagnosis of parasitic infections, allergic disease, neoplasm or connective tissue disorder. The histopathological findings did not show any distinct vasculitis, but there were obliterative changes of the arterioles. The digital gangrene gradually progressed and was unresponsive to corticosteroid therapy. The patient eventually underwent amputation of the distal phalanges. We applied allogeneic cultured dermal substitute (CDS) to the skin defect. The allogeneic CDS was prepared by culturing fibroblasts on a two-layered sponge of hyaluronic acid and atelo-collagen. This CDS is able to release a number of cytokines including VEGF. The present case had a good clinical result.
authors.affiliation: Department of Dermatology, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan. tossan@wakayama-med.ac.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Ohtani
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Okamoto
authors.forename: Chikako
authors.initials: C
authors.lastname: Kaminaka
authors.forename: Tomoh
authors.initials: T
authors.lastname: Kishi
authors.forename: Mikihisa
authors.initials: M
authors.lastname: Sakurane
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Koji
authors.initials: K
authors.lastname: Uede
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kubo
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Kuroyanagi
authors.forename: Fukumi
authors.initials: F
authors.lastname: Furukawa
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D003937:Diagnosis, Differential; D005385:Fingers / Q000473:pathology* / Q000601:surgery; D005734:Gangrene / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008297:Male; D017768:Skin, Artificial; D014034:Toes / Q000473:pathology* / Q000601:surgery