Acquired Ulcero-Mutilating Bilateral Acro-Osteopathy (Bureau-BarriÃ¨re Syndrome)

Georgi Tchernev; Hristo Mangarov; Ilia Lozev; Ivan Pidakev; Torello Lotti; Uwe Wollina; Serena Gianfaldoni; Kristina Semkova; Jacopo Lotti; Katlein FranÃ§a; Atanas Batashki

doi:10.3889/oamjms.2017.134

Authors

Georgi Tchernev Medical Institute of Ministry of Interior (MVR), Department of Dermatology and Dermatologic Surgery, General Skobelev 79, 1606 Sofia, Bulgaria and Onkoderma Polyclinic for Dermatology and Dermatologic Surgery, Sofia
Hristo Mangarov Medical Institute of Ministry of Interior (MVR), Department of Dermatology and Dermatologic Surgery, General Skobelev 79, 1606 Sofia
Ilia Lozev Institute of Ministry of Interior (MVR), Department of Surgery, General Skobelev 79, 1606 Sofia
Ivan Pidakev Institute of Ministry of Interior (MVR), Department of Surgery, General Skobelev 79, 1606 Sofia
Torello Lotti University of Rome â€œ G.Marconiâ€, Rome
Uwe Wollina Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden
Serena Gianfaldoni University G. Marconi of Rome, Rome
Kristina Semkova St. John's Institute of Dermatology, London
Jacopo Lotti Department of Nuclear, Subnuclear and Radiation Physics, University of Rome "G. Marconi", Rome
Katlein FranÃ§a Institute for Bioethics & Health Policy; Department of Dermatology & Cutaneous Surgery; Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine - Miami, FL
Atanas Batashki Abdominal and Thoracic Surgery, Department of Special Surgery, Medical University of Plovdiv, bul. "Peshtersko shose" Nr 66, 4000 Plovdiv

DOI:

https://doi.org/10.3889/oamjms.2017.134

Keywords:

neuropathy, acquired, eczema, ulcerations, ulcero mutilating lesions, bilateral

Abstract

We present a 35-year-old male patient with Bureau-BarriÃ¨re syndrome. Bureau-BarriÃ¨re syndrome is an ulcero-mutilating acropathy almost invariably associated with excessive alcohol intake. It presents with a triad of trophic skin changes with recurrent ulcerations, bone lesions and nerve damage. The clinical presentation includes chronic painless plantar ulcerations with periulcerous hyperkeratosis, hyperhidrosis, livedoid skin colour, nail dystrophy, widening and infiltration of the toes and common interdigital mycoses. Other non-specific skin changes related to the alcohol consumption are commonly observed as well. The condition affects mainly middle-aged men suffering from alcoholism. Often a bilateral location at the lower limb of male alcoholics has been described, as in our patient. Successful treatment of the Bureau-BarriÃ¨re syndrome requires an interdisciplinary approach. Cessation of alcohol intake and smoking is of paramount importance.

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