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Atrophie blancheL95.01
Synonym(s)
atrophy alba; Atrophy white; capillaritis alba; white atrophy
HistoryThis section has been translated automatically.
Milian, 1929
DefinitionThis section has been translated automatically.
Usually highly painful, chronic vasculopathy of small skin vessels in (frequently localized) chronic venous insufficiency.
EtiopathogenesisThis section has been translated automatically.
Localized chronic venous insufficiency with consecutive chronic vasculopathy with vascular occlusion.
LocalizationThis section has been translated automatically.
Mainly perimalleolar area.
Clinical featuresThis section has been translated automatically.
Three-phase course:
- Inflammatory phase: circumscribed livid-red foci.
- Atrophic phase (white atrophy): Small, roundish, slightly sunken, scarred areas with surrounding brown pigmentation. Mostly capillary ectasia detectable at the margins.
- Ulcerous phase ( atrophy blanch-ulcer): Possible formation of mostly small, less frequently superficial (erosions) or ulcers covering the entire atrophic zone. The clinical feature of these ulcers is a stabbing, persistent pain that is incompatible with the size of the ulcer.
HistologyThis section has been translated automatically.
Arteriolitis, capillaritis, fibrin precipitation, microthrombi, sclerosis, atrophy of the epidermis.
Differential diagnosisThis section has been translated automatically.
Purpura pigmentosa progressiva; secondary depigmented scars; necrobiosis lipoidica
General therapyThis section has been translated automatically.
Treatment of the underlying disease, see chronic venous insufficiency. Particularly important: Elimination of pain symptoms, e.g. by using non-steroidal anti-inflammatory drugs. Combination of wound treatment, local therapy, e.g. soft zinc paste R191, compression and immunosuppression.
External therapyThis section has been translated automatically.
In the inflammatory phase short-term glucocorticoids, e.g. betamethasone ointment(e.g. Betagalen, Betnesol) or 0.1% mometasone (e.g. Ecural fat cream), 0.25% prednicarbate (e.g. Dermatop ointment).
Internal therapyThis section has been translated automatically.
- Acetylsalicylic acid (e.g. ASS) 2-3 g/day. In recurrent cases or marked resistance to therapy glucocorticoids in medium dosages, e.g. prednisolone 40-60 mg/day p.o. with gradual dose reduction (stomach protection!).
- In rare cases of absolute resistance to therapy, the intravenous use of immunoglobulins ( IVIG) is recommended, e.g. with 0.2-1 g/kg bw (Intratect).