Document Detail


The Use of B Vitamins for Cutaneous Ulcerations Mimicking Pyoderma Gangrenosum in Patients With MTHFR Polymorphism.
MedLine Citation:
PMID:  21482894     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Methylenetetrahydrofolate reductase (MTHFR) polymorphisms are associated with thrombophilia and vasculopathy that may result in cutaneous ulceration. Pyoderma gangrenosum (PG) is a clinical diagnosis that may be made following exclusion of alternate causes of ulceration, including vascular inflammatory or occlusive disease, infection, and malignant neoplasm.
OBSERVATIONS: We describe 2 patients with MTHFR polymorphisms discovered during hypercoagulable evaluation for cutaneous ulcerations on the lower extremities. Both patients showed a rapid improvement following treatment with oral vitamin supplementation and local wound care. One patient developed several subsequent ulcers when he decided to discontinue his therapy, and following reinitiation of therapy, the new ulcerations healed. The treatment was tolerated well without any adverse effects.
CONCLUSIONS: MTHFR polymorphisms should be part of a comprehensive laboratory evaluation during hypercoagulable workup. Vitamin supplementation with folic acid (B(9)), pyridoxine hydrochloride (B(6)), and cyanocobalamin (B(12)) may result in healing of cutaneous ulcerations in some patients with MTHFR mutations.
Authors:
Douglas New; Philip Eaton; Al Knable; Jeffrey P Callen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of dermatology     Volume:  147     ISSN:  1538-3652     ISO Abbreviation:  Arch Dermatol     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  450-3     Citation Subset:  AIM; IM    
Affiliation:
Division of Dermatology, University of Louisville, 310 E Broadway, Louisville, KY 40202. jefca@aol.com.
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