Cushing's syndrome and chronic venous ulceration - a clinical challenge

Abstract

Cushing's syndrome is a condition caused by high levels of glucocorticoids, or most commonly as a result of prolonged exposure to exogenous steroids. Clinical features include diabetes, hypertension, obesity, skin atrophy, immune suppression and delayed wound healing. We report a patient with iatrogenic Cushing's syndrome, in whom long-term topical steroid therapy was used to treat varicose eczema, which contributed to the development of type 2 diabetes, morbid obesity, sleep apnoea and chronic wound sepsis. In this case, repeated hospital admissions and systemic antibiotics were associated with considerable comorbidity. Aggressive local treatment, consisting of potassium permanganate soaks and irrigating gels, was highly effective in reducing the amount of exudate, pain and preventing from further deterioration of the patient's legs.

Topical 5% potassium permanganate solution accelerates the healing process in chronic diabetic foot ulcers

“…To the best of our knowledge, the present study is the first demonstrating the efficacy of potassium permanganate as a treatment for diabetic foot ulcers. Previous studies have demonstrated that potassium permanganate solution is an effective auxiliary treatment for weeping varicose eczema ( 18 , 19 ). One study investigated patients with gas gangrene as a complication of trauma wounds, and the results indicated that potassium permanganate treatment helped to eliminate the anaerobic microenvironment and had a therapeutic effect on wound healing ( 20 ).…”

Fabrication of bioactive glass-introduced nanofibrous membranes with multifunctions for potential wound dressing

“…1 However, the chronic, nonhealing wounds are involved progressively in tissue loss and bacterial colonization, particularly in venous stasis, diabetic ulcers, and bed sores, and thus give rise to a big challenge to wound-care product researchers. [2][3][4] It is known that calcium is an important factor in the wound healing of skin and it is assumed to be required for the migration of epidermal cells. 5 Clinically, the direct topical application of calcium to chronic wounds through calcium alginate dressings has been shown to be benecial.…”

What is the evidence for the use of potassium permanganate for wound care?

“…Two small studies (a recently published randomised controlled trial and a microbiological study from 1995) and one case report have investigated the use of potassium permanganate in the management of leg or foot ulcers 5 30 31…”

“…In the case report, a patient who had received long‐term topical steroid therapy to treat varicose eczema had developed chronic wound sepsis 31. Aggressive local treatment consisting of potassium permanganate soaks and irrigating gels reduced the amount of exudate and pain.…”