Leg ulcers due to hyperhomocysteinemia.
Chronic leg ulcers are rare in young adults and generally indicate a vascular cause. We report a case of a 26-year-old man with leg ulcers of eight months duration. Doppler study indicated venous incompetence and a postphlebitic limb. However, as the distribution and number of ulcers was not consistent with stasis alone and no features of collagen vascular disease were noted, a hyperviscosity state was considered and confirmed with significantly elevated homocysteine level in the serum. Administration of vitamins B1, B2, B6 and B12, trimethyl-glycine, mecobalamine, folic acid and povidone iodine dressings with culture-directed antibiotic therapy led to a satisfactory healing of ulcers over a period of one month. Hyperhomocysteinemia must be considered in the differential diagnosis of leg ulcers in young individuals.
Krupa Shankar
D S
DS
Department of Dermatology, Manipal Hospital, Bangalore, Karnataka, India. dermakrupa@yahoo.com
Akhib
Syed
S
D000328:Adult; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D007871:Leg Ulcer / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D008297:Male