title: Therapeutic angiogenesis by controlled-release fibroblast growth factor in a patient with Churg-Strauss syndrome complicated by an intractable ischemic leg ulcer.
abstract: Churg-Strauss syndrome (CSS) causes necrotizing vasculitis affecting small- to medium-sized arteries, mainly in the lungs, gastrointestinal system, heart, kidneys, and skin. Skin lesions sometimes ulcerate because of severe ischemia and become intractable when complicated by bacterial infection. We report a rare case of CSS, characterized by a nonhealing ischemic skin ulcer of the right calf with bacterial infection resistant to antibiotics. After sterile maggot debridement therapy, 2 skin autografts failed. Subsequently, a slow-release formula of basic fibroblast growth factor incorporated in biodegradable gelatin hydrogel was administered into the calf muscles to induce vascular regeneration. The ulcer eventually healed with no recurrence. This report describes the use of controlled-release basic fibroblast growth factor for an ischemic leg ulcer in a patient with CSS, suggesting a possible therapeutic role of this novel neovascularization therapy in treating severe skin lesions complicating autoimmune vasculitis syndromes.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Kawanaka
authors.forename: Gen
authors.initials: G
authors.lastname: Takagi
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Shuhei
authors.initials: S
authors.lastname: Tara
authors.forename: Ikuyo
authors.initials: I
authors.lastname: Takagi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takano
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yasutake
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tabata
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000368:Aged; D001158:Arteries / Q000254:growth & development*; D015267:Churg-Strauss Syndrome / Q000150:complications / Q000188:drug therapy*; D003692:Delayed-Action Preparations; D016222:Fibroblast Growth Factor 2 / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007511:Ischemia / Q000150:complications*; D007871:Leg Ulcer / Q000150:complications*; D008297:Male
chemical_list: D003692:Delayed-Action Preparations; D016222:Fibroblast Growth Factor 2