# A Multiple Synergic Treatment for Non-Healing Ulcer Management in a Patient with Klippel–Trenaunay Syndrome

## TL;DR

This paper presents a successful multi-treatment approach for a severe skin ulcer in a patient with Klippel–Trenaunay syndrome, a rare genetic disorder.

## Contribution

The first reported case of a synergistic treatment combining oxygen-ozone therapy, pulsed magnetic fields, and a topical compound for KTS-related ulcers.

## Key findings

- A combination of oxygen-ozone therapy and pulsed magnetic fields improved the patient's non-healing ulcer.
- A topical formulation containing cocum caprylate, oleic acid, quercetin, and 18-β glycyrrhetinic acid contributed to ulcer healing.
- This case supports a multistep treatment strategy for managing severe symptoms in Klippel–Trenaunay syndrome.

## Abstract

Klippel–Trenanauy syndrome (KTS) is a rare genetic disease determined by overexpression of the phosphatidylinositol-4-5-bisphosphate 3 kinase catalytic subunit (PIK3CA) gene. The clinical presentation is characterized by venous and capillary malformations and lymphatic malformation. To date, no definitive treatment has been suggested in order to improve the clinical symptoms related to the developments of a skin wound. In this case, we describe a young man with KTS that developed a severe skin wound in the lower right limb unresponsive to the common treatment but responsive to a treatment with oxygen-ozone therapy, pulsed magnetic fields (diamagnetic treatment), and topical fixed association of cocum caprylate, oleic acid, quercetin, and 18-β glycyrrhetinic acid. This is the first case that supports a multistep approach to treat a rare and severe disease, and we hope that other studies can support our data.