Diagnostyka Newsy Owrzodzenia

Rzadkie przyczyny trudno gojących się ran: czerniak dystalnych części kończyn

Ten tekst przeczytasz w 2 min.

Czerniak umiejscowiony w obrębie kończyn (acrolentiginous melanoma, ALM) to jedna z rzadkich form tej choroby, cechująca się wysoką złośliwością oraz szybkim przebiegiem. W obrazie klinicznym może przypominać zmiany występujące w innych schorzeniach, takich jak cukrzyca, grzybica lub niewydolność żylna.

Owrzodzenie w przebiegu czerniaka

Na wystąpienie owrzodzeń w przebiegu czerniaka narażeni są przede wszystkim: mężczyźni, pacjenci cierpiący na cukrzycę, nadwagę lub otyłość, osoby pomiędzy 40. a 84. rokiem życia, a także osoby często zażywające kwas acetylosalicylowy oraz palące papierosy.

Badania naukowe dowodzą, że wystąpienie owrzodzeń w przebiegu czerniaka zwiększa ryzyko pojawienia się przerzutów oraz zajęcia wartowniczych węzłów chłonnych. Z tego powodu w grupie pacjentów z wrzodziejącą postacią czerniaka odnotowuje się zmniejszoną przeżywalność w porównaniu do pacjentów, u których owrzodzenia nie wystąpiły.

Czerniak dystalnych części kończyn

W przebiegu czerniaka dystalnych części kończyn zmiany chorobowe umiejscowione są w większości przypadków na podeszwie stopy i zwykle towarzyszy im owrzodzenie.

W przypadku pacjentów z cukrzycą owrzodzenia na podłożu czerniaka zlokalizowane w obrębie kończyn dolnych mogą stwarzać trudności diagnostyczne. Zmiany mogą zostać błędnie rozpoznane jako zespół stopy cukrzycowej lub inne jednostki chorobowe, np. ziarniniak ropny. Do weryfikacji diagnozy w wielu przypadkach prowadzi nieskuteczność standardowego leczenia zalecanego dla ran przewlekłych.

AML może również zostać błędnie rozpoznany jako krwiak podpaznokciowy lub grzybica. We wstępnej fazie rozwoju zmiana przybiera w takim przypadku postać ciemnej plamy pod paznokciem. Odnotowane są również przypadki swędzących, okresowo krwawiących zmian na stopach, które także mogą zostać błędnie rozpoznane jako zmiany grzybicze.

Leczenie ALM

Podstawą terapii jest leczenie chirurgiczne polegające na całkowitym wycięciu zmiany. Zabieg może zostać rozszerzony o limfadenektomię regionalnych węzłów chłonnych. Następnie usuwa się również bliznę pooperacyjną wraz z marginesem zdrowej tkanki.

U pacjentów ze stwierdzonymi przerzutami stosuje się ponadto leczenie uzupełniające w postaci radio– i chemioterapii (terapia dakarbazyną) oraz immunoterapii (terapia z wykorzystaniem ipilimumabu, pembrolizumabu oraz niwolumabu).

Źródło:

B. Imko-Walczuk, A. Cegielska i in., „Czerniak w populacji chorych po przeszczepieniu narządów, „NOWOTWORY Journal of Oncology” 2012, 62(2): 109-114.

Przeczytaj także: Zdalna diagnostyka owrzodzeń żylnych – jak ją przeprowadzić?

Przeczytaj bezpłatnie pokrewny artykuł w czasopiśmie „Chirurgia Plastyczna i Oparzenia”:

403 thoughts on “Rzadkie przyczyny trudno gojących się ran: czerniak dystalnych części kończyn

  1. There are some interesting closing dates in this article however I don’t know if I see all of them center to heart. There is some validity however I’ll take hold opinion until I look into it further. Good article , thanks and we wish extra! Added to FeedBurner as well

  2. com 20 E2 AD 90 20Naturalna 20Viagra 20Opinie 20 20Viagra 20Tekli 20Tablet 20Fiyat naturalna viagra opinie I receive calls from investors, and they want definiteanswers about what will happen to the government if they aregoing to invest billions on Italian bonds, said RobertoD Alimonte, one of Italy s top political analysts buy cialis daily online

  3. I’m impressed, I have to say. Actually hardly ever do I encounter a blog that’s each educative and entertaining, and let me let you know, you’ve hit the nail on the head. Your idea is outstanding; the difficulty is one thing that not sufficient people are talking intelligently about. I’m very joyful that I stumbled throughout this in my seek for one thing regarding this.

  4. Good blog! I really love how it is simple on my eyes and the data are well written. I’m wondering how I could be notified whenever a new post has been made. I’ve subscribed to your RSS which must do the trick! Have a nice day!

  5. Greetings from Carolina! I’m bored to death at work so I decided to browse your website on my iphone during lunch break. I love the knowledge you provide here and can’t wait to take a look when I get home. I’m amazed at how fast your blog loaded on my cell phone .. I’m not even using WIFI, just 3G .. Anyhow, amazing site!

  6. Definitely consider that that you said. Your favorite justification appeared to be on the internet the simplest factor to keep in mind of. I say to you, I definitely get annoyed at the same time as folks think about issues that they plainly don’t recognize about. You controlled to hit the nail upon the top and defined out the whole thing with no need side-effects , folks can take a signal. Will probably be again to get more. Thank you

  7. Unquestionably believe that which you said. Your favorite
    justification seemed to be on the net the easiest thing to be
    aware of. I say to you, I certainly get annoyed
    while people consider worries that they plainly don’t know
    about. You managed to hit the nail upon the top and also defined out the whole thing
    without having side-effects , people could take a signal.
    Will probably be back to get more. Thanks

  8. Excellent post. I was checking continuously this blog and I am impressed! Extremely useful information specifically the last part 🙂 I care for such information much. I was looking for this certain information for a very long time. Thank you and best of luck.

  9. It’s a pity you don’t have a donate button! I’d most certainly donate to this fantastic blog! I suppose for now i’ll settle for book-marking and adding your RSS feed to my Google account. I look forward to new updates and will share this website with my Facebook group. Chat soon!

  10. Simply desire to say your article is as amazing. The clearness for your post is just excellent and i can assume you’re a professional on this subject. Fine with your permission allow me to take hold of your feed to stay updated with drawing close post. Thank you one million and please continue the rewarding work.

  11. Sight Care is a daily supplement proven in clinical trials and conclusive science to improve vision by nourishing the body from within. The Sight Care formula claims to reverse issues in eyesight, and every ingredient is completely natural.

  12. Wow, incredible blog format! How long have you ever been blogging
    for? you make running a blog glance easy.
    The overall look of your site is magnificent, as neatly as the content material!

  13. I’ve been browsing online more than 2 hours today, yet I
    never found any interesting article like yours. It is pretty
    worth enough for me. In my view, if all website owners and bloggers made
    good content as you did, the internet will be much more useful than ever before.

  14. magnificent post, very informative. I’m wondering why the other
    specialists of this sector do not notice this. You must continue your writing.
    I’m confident, you’ve a huge readers’ base already!

  15. Today, while I was at work, my sister stole my apple ipad and tested to see if it can survive a
    25 foot drop, just so she can be a youtube sensation. My apple ipad is now
    broken and she has 83 views. I know this is
    totally off topic but I had to share it with someone!

  16. Boostaro increases blood flow to the reproductive organs, leading to stronger and more vibrant erections. It provides a powerful boost that can make you feel like you’ve unlocked the secret to firm erections

  17. Puravive introduced an innovative approach to weight loss and management that set it apart from other supplements. It enhances the production and storage of brown fat in the body, a stark contrast to the unhealthy white fat that contributes to obesity.

  18. Cortexi is an effective hearing health support formula that has gained positive user feedback for its ability to improve hearing ability and memory. This supplement contains natural ingredients and has undergone evaluation to ensure its efficacy and safety. Manufactured in an FDA-registered and GMP-certified facility, Cortexi promotes healthy hearing, enhances mental acuity, and sharpens memory.

  19. FitSpresso stands out as a remarkable dietary supplement designed to facilitate effective weight loss. Its unique blend incorporates a selection of natural elements including green tea extract, milk thistle, and other components with presumed weight loss benefits.

  20. Prostadine is a dietary supplement meticulously formulated to support prostate health, enhance bladder function, and promote overall urinary system well-being. Crafted from a blend of entirely natural ingredients, Prostadine draws upon a recent groundbreaking discovery by Harvard scientists. This discovery identified toxic minerals present in hard water as a key contributor to prostate issues.

  21. Claritox Pro™ is a natural dietary supplement that is formulated to support brain health and promote a healthy balance system to prevent dizziness, risk injuries, and disability. This formulation is made using naturally sourced and effective ingredients that are mixed in the right way and in the right amounts to deliver effective results.

  22. TropiSlim is a unique dietary supplement designed to address specific health concerns, primarily focusing on weight management and related issues in women, particularly those over the age of 40. TropiSlim targets a unique concept it refers to as the „menopause parasite” or K-40 compound, which is purported to be the root cause of several health problems, including unexplained weight gain, slow metabolism, and hormonal imbalances in this demographic.

  23. EyeFortin is a natural vision support formula crafted with a blend of plant-based compounds and essential minerals. It aims to enhance vision clarity, focus, and moisture balance.

  24. GlucoBerry is one of the biggest all-natural dietary and biggest scientific breakthrough formulas ever in the health industry today. This is all because of its amazing high-quality cutting-edge formula that helps treat high blood sugar levels very naturally and effectively.

  25. Sight Care is a daily supplement proven in clinical trials and conclusive science to improve vision by nourishing the body from within. The Sight Care formula claims to reverse issues in eyesight, and every ingredient is completely natural.

  26. Kerassentials are natural skin care products with ingredients such as vitamins and plants that help support good health and prevent the appearance of aging skin. They’re also 100% natural and safe to use. The manufacturer states that the product has no negative side effects and is safe to take on a daily basis. Kerassentials is a convenient, easy-to-use formula.

  27. Elevate your vitality with Alpha Tonic – the natural solution to supercharge your testosterone levels. When you follow our guidance, experience improved physical performance

  28. Well done on the article! The content is informative, and I believe adding more images in your upcoming pieces could be beneficial. Have you thought about that?

  29. Fantastic article! The insights provided are valuable, and I think incorporating more images in your future articles could make them even more engaging. Have you thought about that?

  30. I cling on to listening to the newscast speak about receiving free online grant applications so I have been looking around for the best site to get one. Could you tell me please, where could i acquire some?

  31. LeanBiome is also unique in that it is caffeine-free, making it a safe and effective choice for those who are sensitive to caffeine. The product is easy to incorporate into your daily routine and can be taken with or without food. With regular use, LeanBiome can help to support healthy weight loss, reduce belly fat, and improve overall gut health.

  32. LeanBiome is a cutting-edge supplement that offers a new approach to weight management. By targeting the root cause of weight gain – an imbalanced gut microbiome – LeanBiome provides a sustainable solution to healthy weight loss. Its unique combination of clinically-researched 'lean bacteria’ species and Greenselect Phytosome make it a powerful and effective supplement that is backed by real-world results.

  33. Awesome blog! Is your theme custom made or did you download it from somewhere? A theme like yours with a few simple adjustements would really make my blog jump out. Please let me know where you got your theme. Many thanks

  34. Thanks a lot for sharing this with all of us you really know what you are talking about! Bookmarked. Please also visit my site =). We could have a link exchange arrangement between us!

  35. Good post. I be taught one thing more challenging on different blogs everyday. It’ll all the time be stimulating to learn content material from different writers and observe somewhat something from their store. I’d favor to use some with the content material on my weblog whether or not you don’t mind. Natually I’ll give you a link on your internet blog. Thanks for sharing.

  36. Wow, wonderful blog structure! How long have you ever
    been blogging for? you make blogging look easy. The entire look of your website is
    fantastic, let alone the content material! You can see similar here sklep online

  37. Good day! I know this is kind of off topic but I was wondering if you knew where I could
    get a captcha plugin for my comment form? I’m using the same blog platform as yours and I’m
    having trouble finding one? Thanks a lot! I saw similar here:
    Najlepszy sklep

  38. Hi! Do you know if they make any plugins to help with Search Engine Optimization? I’m trying to
    get my blog to rank for some targeted keywords but
    I’m not seeing very good gains. If you know of any please share.
    Kudos! You can read similar blog here: Sklep online

  39. It’s actually a nice and useful piece of information. I’m glad that you shared this helpful information with us. Please keep us up to date like this. Thanks for sharing.

  40. I’ll right away grab your rss feed as I can’t in finding your email subscription hyperlink or e-newsletter service. Do you’ve any? Kindly let me realize in order that I may subscribe. Thanks.

  41. Normally I don’t learn article on blogs, however I wish to say that this write-up very forced me to take a look at and do so! Your writing style has been surprised me. Thanks, quite great article.

  42. Hello there! Do you know if they make any plugins to help with SEO?
    I’m trying to get my site to rank for some targeted keywords but
    I’m not seeing very good success. If you know of any please share.
    Kudos! You can read similar blog here: Scrapebox List

  43. My spouse and I stumbled over here from a different page and thought I should check things out. I like what I see so now i am following you. Look forward to going over your web page again.

  44. You really make it seem so easy with your presentation but I find this topic to be actually something that I think I would never understand. It seems too complex and extremely broad for me. I am looking forward for your next post, I’ll try to get the hang of it!

  45. Thanks for your own hard work on this website. Debby loves conducting investigations and it’s obvious why. We all hear all of the lively form you produce both useful and interesting ideas by means of your web blog and even encourage contribution from people on this content and our own girl is without question becoming educated so much. Have fun with the rest of the new year. You are always performing a glorious job.

  46. hello!,I love your writing so much! percentage we communicate more about your post on AOL? I need a specialist on this house to unravel my problem. Maybe that’s you! Taking a look ahead to look you.

  47. I found your blog web site on google and test just a few of your early posts. Continue to keep up the superb operate. I just extra up your RSS feed to my MSN Information Reader. Looking for forward to studying extra from you in a while!…

  48. I’ve recently started a website, the info you offer on this web site has helped me tremendously. Thanks for all of your time & work. „Patriotism is often an arbitrary veneration of real estate above principles.” by George Jean Nathan.

  49. I’ve been exploring for a little bit for any high quality articles or blog posts in this kind of house . Exploring in Yahoo I at last stumbled upon this site. Reading this info So i’m happy to express that I’ve a very excellent uncanny feeling I found out just what I needed. I most definitely will make sure to do not fail to remember this web site and give it a glance on a constant basis.

  50. Thanx for the effort, keep up the good work Great work, I am going to start a small Blog Engine course work using your site I hope you enjoy blogging with the popular BlogEngine.net.Thethoughts you express are really awesome. Hope you will right some more posts.

  51. Thank you, I’ve recently been looking for information about this subject for ages and yours is the best I’ve discovered till now. But, what about the conclusion? Are you sure about the source?

  52. I have been exploring for a little for any high quality articles or weblog posts on this kind of space . Exploring in Yahoo I finally stumbled upon this web site. Studying this info So i am happy to convey that I have a very excellent uncanny feeling I discovered exactly what I needed. I so much no doubt will make certain to do not put out of your mind this site and provides it a glance regularly.

  53. I will immediately grasp your rss as I can’t to find your e-mail subscription link or e-newsletter service. Do you’ve any? Kindly permit me understand so that I could subscribe. Thanks.

  54. hi!,I really like your writing so so much! proportion we communicate more about your post on AOL? I need an expert in this house to unravel my problem. May be that’s you! Having a look forward to peer you.

  55. I just couldn’t depart your web site before suggesting that I extremely enjoyed the standard info a person provide for your visitors? Is going to be back often in order to check up on new posts

  56. What a brilliant way to start the week with your post! This Monday feels even more special thanks to your words. I’m curious if you’ll add more visuals in the future, as it could enhance the storytelling.

  57. Excellent blog right here! Additionally your web site a lot up fast! What web host are you the usage of? Can I get your affiliate link on your host? I wish my web site loaded up as fast as yours lol

  58. Just wish to say your article is as surprising. The clearness in your post is simply great and i can assume you are an expert on this subject. Fine with your permission let me to grab your RSS feed to keep up to date with forthcoming post. Thanks a million and please continue the gratifying work.

  59. Very interesting points you have noted, thankyou for posting. „History is a cyclic poem written by Time upon the memories of man.” by Percy Bysshe Shelley.

Dodaj komentarz

Twój adres e-mail nie zostanie opublikowany.