Management guideline for <scp>W</scp>erner syndrome 2020. 6. Skin ulcers associated with <scp>W</scp>erner syndrome: Prevention and non‐surgical and surgical treatment

  • Yoshitaka Kubota
    Department of Plastic, Reconstructive, and Aesthetic Surgery Chiba University Graduate School of Medicine Chiba Japan
  • Minoru Takemoto
    Department of Diabetes, Metabolism and Endocrinology, School of Medicine International University of Health and Welfare Chiba Japan
  • Toshibumi Taniguchi
    Department of Infectious Diseases Chiba University Hospital Chiba Japan
  • Sei‐ichiro Motegi
    Department of Dermatology Gunma University Graduate School of Medicine Maebashi Japan
  • Akira Taniguchi
    Department of Orthopaedic Surgery Nara Medical University Nara Japan
  • Hironori Nakagami
    Department of Health Development and Medicine Osaka University Graduate School of Medicine Osaka Japan
  • Yoshiro Maezawa
    Department of Endocrinology, Hematology and Gerontology Chiba University Graduate School of Medicine Chiba Japan
  • Masaya Koshizaka
    Department of Endocrinology, Hematology and Gerontology Chiba University Graduate School of Medicine Chiba Japan
  • Hisaya Kato
    Department of Endocrinology, Hematology and Gerontology Chiba University Graduate School of Medicine Chiba Japan
  • Seijiro Mori
    Center for the Promotion of Clinical Investigation Tokyo Metropolitan Geriatric Hospital Tokyo Japan
  • Kazuhisa Tsukamoto
    Department of Internal Medicine Teikyo University School of Medicine Tokyo Japan
  • Masafumi Kuzuya
    Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Institutes of Innovation for Future Society Nagoya University Nagoya Japan
  • Koutaro Yokote
    Department of Endocrinology, Hematology and Gerontology Chiba University Graduate School of Medicine Chiba Japan

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<jats:sec><jats:title>Aim</jats:title><jats:p>To provide guidelines on the diagnosis, treatment, and prevention of skin ulcers in Werner syndrome.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This article was based on literature from 1996, when WRN was identified as a gene responsible for Werner syndrome, and we evaluated several authentic clinical cases of genetically diagnosed patients. There were 63 patients with Werner syndrome in the Japanese reports retrieved from Medical Online between January 1996 and December 2017. There were 56 patients with Werner syndrome in English reports written by Japanese authors and retrieved from PubMed during the same period.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Records on skin ulcers were found in 27 (43%) out of 63 patients and 22 (40%) out of 56 patients from the Japanese and English reports, respectively. The reported ulcers were often located at the distal one‐third of the lower legs. There were 8 patients with callosities in the foot in the Japanese reports and 9 patients in the English reports. A skin ulcer in Werner syndrome is generally intractable. Weight‐bearing ulcers or callosity should be critically assessed in surgical procedures because they have effects on patient pain and gait. By adopting a recently advanced technique to facilitate wound healing, the cases of ulcers that were difficult to treat and those requiring major operations can be closed with minimally invasive surgery.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Skin ulcers in Werner syndrome are refractory, and they lead to reduced quality of life of patients. A callosity in Werner syndrome is an important therapeutic target for the prevention of ulcers. <jats:bold>Geriatr Gerontol Int 2021; 21: 153–159</jats:bold>.</jats:p></jats:sec>

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