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Image of the month
Image of the Month Sanjiv Chopra, Section Editor
Question: A 41-year-old man presented with ulceration of the skin over lower part of the left shin with edema and redness around the margin and formation of necrotic slough on the ulcer. Serosanguineous fluid oozed from the ulcer, which was tender (Figure A). There was no history of trauma. At the local hospital, he was initially diagnosed as having necrotizing fasciitis and underwent several debridements with local care and intravenous antibiotic therapy without any improvement. What initial factors in the medical history might be relevant? What is the diagnosis? Also, there was marked improvement with near-total resolution of the cutaneous findings after institution of a treatment. What treatment modalities can be used to treat this condition?
GASTROENTEROLOGY 2000;118:654
Look on page 809 for the answer and see the Gastroenterology website (http://www. gastrojournal.org) for more information on submitting your favorite image to Image of the Month. NASHED BOTROS, M.D LAWRENCE PICKOVER, M.D. KIRON M. DAS, M.D., Ph.D. Department of Medicine UMDNJ–Robert Wood Johnson Medical School New Brunswick, New Jersey
r 2000 by the American Gastroenterological Association 0016-5085/00/$10.00 doi:10.1053/gg.2000.6760
Question: A 41-year-old man presented with ulceration of the skin over lower part of the left shin with edema and redness around the margin and formation of necrotic slough on the ulcer. Serosanguineous fluid oozed from the ulcer, which was tender (Figure A). There was no history of trauma. At the local hospital, he was initially diagnosed as having necrotizing fasciitis and underwent several debridements with local care and intravenous antibiotic therapy without any improvement. What initial factors in the medical history might be relevant? What is the diagnosis? Also, there was marked improvement with near-total resolution of the cutaneous findings after institution of a treatment. What treatment modalities can be used to treat this condition?
GASTROENTEROLOGY 2000;118:654
Look on page 809 for the answer and see the Gastroenterology website (http://www. gastrojournal.org) for more information on submitting your favorite image to Image of the Month. NASHED BOTROS, M.D LAWRENCE PICKOVER, M.D. KIRON M. DAS, M.D., Ph.D. Department of Medicine UMDNJ–Robert Wood Johnson Medical School New Brunswick, New Jersey
r 2000 by the American Gastroenterological Association 0016-5085/00/$10.00 doi:10.1053/gg.2000.6760