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Forearm contusion wounds with Sjögren’s syndrome

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l5509 (Published 03 October 2019) Cite this as: BMJ 2019;367:l5509
  1. Jianchi Li, consultant1 2,
  2. Xiaohua Pan, professor1 2,
  3. Tun Hing Lui, consultant3,
  4. Xiaomin Wu, consultant1 2
  1. 1Guangdong Provincial Engineering Research Center of Wound Repair and Regenerative Medicine, Guangdong Provincial Academician Workstation of Wound Repair and Regenerative Medicine, Department of Trauma and Orthopedics, Affiliated Baoan Hospital of Shenzhen of Southern Medical University, The 2nd Affiliated Hospital of Shenzhen University, The 8th People’s Hospital of Shenzhen, Shenzhen, China
  2. 2Jinan University School of Medicine, Guangzhou, Guangdong Province, China
  3. 3Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, Hong Kong, China
  1. Correspondence to X Pan 568282414{at}qq.com

These are unhealed wounds (fig 1) (with ulceration, skin eruption, and yellowish exudates) on the left forearm of a patient with Sjögren’s syndrome. The wounds were from a contusion injury that occurred two months earlier, when a metal plate had hit the patient’s forearm.

The patient was a 76 year old man. The wounds repeatedly broke down, despite daily dressing. His serum cortisol was reduced, anti-nuclear antibody elevated, and anti-SSA/Ro60KD and anti-SSA/Ro52KD antibodies were positive. Wound swab culture yielded Pseudomonas aeruginosa but the wounds remained unhealed, despite intravenous levofloxacin.

The progression of this case was believed to be due to inadequately treated Sjögren’s syndrome.

Cutaneous vasculitis occurs in around 30% Sjögren’s syndrome cases, and may account for difficult wound healing.1

Footnotes

  • Patient consent obtained.

References

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