Hyperhomocysteinemia in patients with stasis dermatitis and ulcer: a novel finding with important therapeutic implications.

BACKGROUND: Although homocysteine (Hcy) has profound effects concerning vascular lesions and thrombosis, it has not previously been investigated in patients with stasis dermatitis and ulcer.
OBJECTIVE: To evaluate plasma Hcy levels in patients with stasis dermatitis and ulcer.
METHODS: A total of 25 patients (17 male, eight female; mean age of 36 +/- 5.97 years) with stasis dermatitis, 40 patients with stasis ulcer (27 male, 13 female; mean age of 38.5 +/- 7.96 years) and 35 healthy control individuals (25 male, 10 female; mean age of 36.9 +/- 6.49 years) were included in this study. Patients taking vitamin supplements or patients with folic acid or vitamin B12 deficiency, diabetes mellitus, chronic hepatitis, renal failure and chronic alcoholism which might affect Hcy levels were excluded from the study.
RESULTS: Hcy levels were found to be elevated in patients with stasis dermatitis (p = 0.00) and stasis ulcer (p = 0.00) compared to healthy controls with a median (range) of 19.1 micromol/l (15-28), 18.98 micromol/l (15-29), and 8.1 micromol/l (5-12.2), respectively. There was no statistically significant difference in Hcy level in patients with stasis dermatitis and ulcer (p = 0.877).
CONCLUSION: As hyperhomocysteinemia can be treated by selected vitamin supplementation even in patients with normal serum vitamin concentrations, ulcer formation might be prevented by lowering Hcy in the clinical stage of stasis dermatitis.