Dermal ulcers

CoUagenase specifically cataly2es the hydrolysis of coUagen, and is used in debridement of dermal ulcers and bums (191). It, like chymopapain, is also useful in the treatment of herniated lumbar disks (192,193). The rationale for coUagenase treatment in this instance is based on the preponderance of coUagen in herniated disk tissue, and the inabiUty of other en2ymes to dissolve coUagen (194). 

Deoxyribonuclease (DNAase), an enzyme that degrades deoxyribonucleic acid, has been used in patients with chronic bronchitis, and found to produce favorable responses presumably by degrading the DNA, contributed by cell nuclei, to inflammatory mucus (213). Lysozyme [9001 -63-2] hydrolyzes the mucopeptides of bacterial cell walls. Accordingly, it has been used as an antibacterial agent, usually in combination with standard antibiotics. Topical apphcations are also useful in the debridement of serious bums, cellulitis, and dermal ulceration. 

The dermal LDso in rabbits was 1.09ml/kg. A 10% solution applied to the skin of mice produced dermal ulceration. 

For debriding chronic dermal ulcers and severely burned areas. 

Unlabeled Uses Topical Prophylaxis of minor bacterial skin infections, treatment of dermal ulcer... 

Dermal Bd Wt 2.3 (temporary weight loss) 2.3 (severe dermal ulcers) ... 

Table 2 compares the clinical data in our patients with heroin related amyloidosis (n=24) and heroin related FSGS (n=30) [50]. Most patients with renal amyloidosis had exhausted their intravenous access for drug abuse and resorted to subcutaneous "skinpopping". Almost all patients used heroin, some mixed with cocaine, and two patients reportedly abused only pentazocine and tripelennamine [64]. All patients had chronic dermal ulcerations and suppurative skin infections. 

Chronic overexposure may produce the following pneumonitis and pulmonary edema upon repeated inhalation throat ulceration and esophageal irritation upon oral ingestion dermal ulceration, allergic dermatitis, and sensitization upon skin exposure and keratitis, conjunctivitis, or corneal ulceration upon... 

Use Prevention, treatment of infection in second-and third-degree bums, protection against conversion from partial-to full-thickness wounds (infection causes extended tissue destruction). Treatment of minor bacterial skin infection and dermal ulcer. Half-life UK Onset on contact Peaks 2 1 hours Duration as long as applied... 

All patients had chronic dermal ulcerations and suppurative skin infections. 

Bacitracin, which inhibits cell wall synthesis, is active against Gram-positive bacteria. In combination with polymyxin and neomycin, it is often used in the treatment of topical infections as well as open infections such as infected eczema, dermal ulcers, and surgical wounds. The parenteral administration of bacitracin may cause nephrotoxicity. 

Collagenase contributes to the formation of granulation tissue and subsequent epithelialization of dermal ulcers and severely burned areas. It is indicated in the debriding chronic dermal ulcers and severely burned areas. 

Collagenase, an enzyme concentrate derived from Clostridium histolytica, is used to promote debridement of necrotic tissue in dermal ulcers and severe bums. 

Bacitracin is available in ophthalmic and dermatologic ointments the antibiotic also is available as a powder for the preparation of topical solutions. The ointments are applied directly to the involved surface one or more times daily. A number of topical preparations of bacitracin, to which neomycin or polymyxin or both have been added, are available, and some contain the three antibiotics plus hydrocortisone. For open infections such as infected eczema and infected dermal ulcers, the local application of the antibiotic may be of some help in eradicating sensitive bacteria. Bacitracin rarely produces hypersensitivity. Suppurative conjunctivitis and infected comeal ulcer respond well to the topical use of bacitracin when caused by susceptible bacteria. Bacitracin has been used with limited success for eradication of nasal carriage of staphylococci. Oral bacitracin has been used with some success for the treatment of antibiotic-associated diarrhea caused by C. difficile. Serious nephrotoxicity results from the parenteral use of bacitracin. Hypersensitivity reactions rarely result from topical application. 

Acute lymphocytic leukemia non-Hodgkin s lymphoma Chronic dermal ulcers severe skin burns... 

Tyrone J W, et al. (2000). Collagen-embedded platelet-derived growth factor DNA plasmid promotes wound healing in a dermal ulcer model. J. Surg. Res. 93 230-236. 

Boxer, A.M., Gottesman, N., Bernstein, H., Mandl, I. 1969. Debridement of dermal ulcers and decubiti with collagenase. Geriatrics 24(7), 75-86. 

Mustoe, T. A., Pierce, G. R, Morishima, C., and Deuel, T. R 1991. Growth factor-induced acceleration of tissue repair through direct and inductive activities in a rabbit dermal ulcer model. Journal of Clinical Investigation, 87, 694-703. 

Collagen gel Skin PDGF-A gene — Rabbit dermal ulcer... 

Neutrophils also contain several cationic serine proteases (5). The enzyme, elastase, is particularly abundant The amount of elastase contained in the granules of a single neutrophil is in excess of one picogram (4) Several groups have used specific inhibitors as well as antisera to demonstrate that elastase or an elastase-like protease is abundant in chronic wound fluids (13,22-24). Mean levels of elastase activity is approximately 12-fold higher in fluids of chronic dermal ulcers compared to surgical... 

Additional serine proteases have been found in chronic wounds and neutrophils probably are also the primary source of these enzymes. These include cathepsin G, another cationic serine protease with broad substrate specificity, urokinase-type plasminogen activator (itfA), and protease 3 (3,32-35). In all probability, when looked for, elevated levels of additional neutrophil proteases will be found in chronic dermal ulcers. 

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