Hyperbaric Oxygen in Intractable Psoriatic Leg Ulcer: Case Report and Literature Review

Abstract

Psoriasis is a chronic, remitting and relapsing, immune-mediated inflammatory skin disorder with a strong genetic predisposition. It is also associated with other serious health conditions, such as diabetes, heart disease and depression. The high morbidity in patients with psoriasis results from severe clinical manifestations and/or adverse effects of treatment. The Undersea and Hyperbaric Medical Society and Federal Medicare and Medicaid Services have approved the use of hyperbaric oxygen for more than 15 indications, including wound healing, infections and late effects of radiation, which are largely unresponsive to conventional treatments. In the literature data have been reported showing that the hyperbaric oxygen has anti-inflammatory effects and other positive influences on the immune system, laying the foundations for the rationale of psoriatic cutaneous wound treatment with hyperbaric oxygen therapy. Here we present the case of a patient with intractable psoriatic leg ulcer, and failure of the conventional therapy. Interestingly he exhibited a marked improvement and a complete “restitutio ad integrum” with the use of hyperbaric oxygen. No adverse effects were identified. The hyperbaric oxygen therapy may possess potential therapeutic efficacy in the management of psoriatic ulcers. We hope, for the near future, that this will provide a basis for elucidating the mechanisms of action and consequently paving the way for further and larger controlled studies.