Case Of Pyoderma Gangrenosum Research Articles

A case of pyoderma gangrenosum in the forearm associated with ulcerative colitis

A case of pyoderma gangrenosum in the forearm associated with ulcerative colitis

A resistant case of pyoderma gangrenosum with monoclonal gammopathy of unknown significance showing excellent response to combination therapy of methyl prednisolone pulse and oral cyclosporine

Pyoderma gangrenosum (PG) is a rare and painful skin condition of uncertain etiology characterized by one or more areas of chronic ulceration with well-demarcated and undermined borders. PG often occurs in patients who have other diseases (arthritis, inflammatory bowel disease, hematologic dyscrasias, monoclonal gammopathy of unknown significance, etc). Immunosuppressive agents have been used for its management. Among them, although corticosteroid is known as the most effective agent, other immunosuppressants including cyclosporine have been selected for patients with PG who were refractory to systemic steroids. Here, we report a case of PG with monoclonal gammopathy of unknown significance, resistant to systemic steroids and cyclosporine, that was successfully treated with a combination of cyclosporine and methyl prednisolone pulse.

Case of Pyoderma Gangrenosum Associated with Ulcerative Colitis Successfully Treated with Infliximab

Case of Pyoderma Gangrenosum Associated with Ulcerative Colitis Successfully Treated with Infliximab

Pyoderma Gangrenosum in Revision Total Hip Arthroplasty: Clinical and Histopathological Findings with a Seven-Year Follow-up: A Case Report.

We describe the clinical and histopathological findings associated with a case of pyoderma gangrenosum (PG) after revision total hip arthroplasty. The patient developed an expanding purple-red, necrotic, ulcerative lesion at the surgical site, which was initially suspected to be either a surgical-site infection or warfarin-induced skin necrosis. After treatment with empiric intravenous antibiotics, surgical debridement, and vacuum-assisted closure of the wound, the patient had a painless hip with a remodeled scar and was asymptomatic at the seven-year follow-up. Confirmation of the diagnosis of surgical-site PG requires clinical-pathological correlation and familiarity with the PG skin lesion. Treatment of PG differs from treatment of infection; therefore, misdiagnosis and surgical treatment may exacerbate the clinical findings in PG.

31: A rare case of pyoderma gangrenosum and the effects of pathergy in a postpartum patient

31: A rare case of pyoderma gangrenosum and the effects of pathergy in a postpartum patient

A Pyoderma Gangrenosum Case Located on the Scalp

A Pyoderma Gangrenosum Case Located on the Scalp

A Case of Pyoderma Gangrenosum Responsive to Systemic Corticosteroids

Pyoderma gangrenosum is a rare painful ulcerative disorder of the skin that can prove recalcitrant to treatment. The diagnosis of pyoderma gangrenosum is made based on clinical features after excluding other ulcerative conditions that can present in a similar fashion. We present the case of a 58-year-old woman seen in the hospital for a large nonhealing ulcer present on the lower leg, which was responsive to treatment with systemic corticosteroids. The clinical findings and response to treatment are consistent with a diagnosis of pyoderma gangrenosum. Although many reported cases are associated with an underlying disease process, in this case, no associated condition was detected, despite an extensive work-up. This case describes the essential process of considering other ulcerative disorders in the differential diagnosis when evaluating a possible case of pyoderma gangrenosum, the search for associated underlying conditions, and consideration of treatment options once a diagnosis of pyoderma gangrenosum is made.

Pyoderma gangrenosum et aortite neutrophilique précédant l’apparition d’une polyarthrite rhumatoïde

We report a case of pyoderma gangrenosum (PG) associated with a complication comprising ascending aortic dissection (neutrophilic aortitis) in a setting of rheumatoid arthritis (RA). A 79-year-old female patient was hospitalized in late 2009 for vegetating PG. Treatment with general steroids followed by colchicine and topical steroids resulted in complete healing of skin lesions. During hospitalization, the patient presented dissection of the ascending part of the aorta, for which emergency surgery proved effective. Histological examination of the excised tissue revealed diffuse neutrophilic aortitis. Diagnoses of Takayashu's disease and of lupus were ruled out. A chest CT scan showed interstitial lung disease with mild lymphocytosis in the bronchoalveolar fluid, but with no isolated pathogenic organisms. Relapse of skin lesions occurred 3 and 4 years later, associated with the development of RA, and worsening of the interstitial lung disease was noted in a scan carried out it in 2013, following which stabilization was observed in April 2014. There was no recurrence of the PG lesions. To our knowledge, no other cases involving association of neutrophilic aortitis with PG and RA has been published to date. The literature describes the emergence of the concept of systemic neutrophilic dermatoses, and this notion is reinforced by the presence of a cutaneous and aortic site of the neutrophilic disease in a single patient.

A case of pyoderma gangrenosum associated with anterior necrotizing scleritis in a patient with ulcerative colitis

A case of pyoderma gangrenosum associated with anterior necrotizing scleritis in a patient with ulcerative colitis

Pyoderma gangrenosum granulomateux profond : une forme originale de pyoderma gangrenosum ?

We report an extremely rare case of pyoderma gangrenosum with the clinical features of pyoderma gangrenosum but with unusual histopathological findings and deep massive granulomatous infiltration through the dermis. A 15-year-old girl presented with a two-month history of deep ulcers on the lower legs and forehead. She also presented abdominal pain with diarrhea and vomiting that disappeared after symptomatic treatment. Histology showed extensive granulomatous infiltration in the dermis and hypodermis and a micro-abscess in the dermis. An abdominopelvic CT scan revealed peritoneal fluid and tissue formation in a lateral carotid cave (6.56 cm/4.56 cm). Colonoscopy was normal. The patient was treated with oral prednisone, resulting in resolution of the problems of cutaneous lesions, peritoneal fluid and tissue formation. Our case involves a rare presentation of pyoderma gangrenosum (PG) inconsistent with any of the four clinical variants of PG and characterized histologically by the presence of deep granulomas in the dermis and hypodermis. Despite the atypical clinical presentation and unusual histopathological findings, PG seemed the most likely diagnosis after infectious diseases had been ruled out; the good outcome achieved with oral corticosteroids supported our diagnosis.

PIODERMA GANGRENOSO EXTENSO EM UM PACIENTE NÃO ADERENTE AO TRATAMENTO

Fundamentos e Objetivos: Apesar do trauma térmico no grande queimado ser agudo e do pioderma gangrenoso ser uma doença imunomediada, muitos aspectos são comuns nesses dois grupos de pacientes. Defendemos que as regras usadas na determinação da percentagem de pele acometida no grande queimado sejam também usadas nos casos extensos de pioderma gangrenoso. Bem como uma rotina de suporte clínico - claramente seguida nos queimados - mas nem sempre nos pacientes com pioderma gangrenoso.Relato de caso: Paciente masculino com quadro clínico extenso de pioderma gangrenoso, não aderente ao tratamento, apresentava lesões úlcero vegetantes e cicatrizes cribiformes. Após apresentar melhora clínica, não retornou em consulta.Conclusões: Em casos graves e extensos, nos quais a percentagem de acometimento da pele supere 20% da superfície corporal, a abordagem do pioderma gangrenoso deve ser semelhante a de um grande queimado, com exame clínico e avaliação da hidratação corporal periódicos.

Ulcerative form of pyoderma gangrenosum (a case study description)

The authors describe a case of pyoderma gangrenosum when the patient’s external therapy included Tecasorb disposable sterile tissue-based absorption wipes featuring activated carbon manufactured based on nanotechnologies. The authors describe and confirm that the following present-day study method can be used for diagnostics of the disease: mass spectrometry of microbial agents in biological environments.

Pyoderma Gangrenosum after Minor Trauma in a Pregnant Woman, Mistaken for Necrotizing Fasciitis: Report of a Case and Literature Review

Pyoderma gangrenosum is an ulcerative, non-infectious skin disorder. However, it can be mistaken as necrotizing fasciitis, a life-threatening infective condition. We describe here a case of pyoderma gangrenosum after minor trauma treated as necrotizing fasciitis. Case report and literature review. A 27-year-old pregnant nurse had a pretibial wound after a fall on a rough surface. When erythema developed and no response to empirical antibiotic therapy was observed, multiple debridements were performed. Paradoxically, her condition became worse. The diagnosis of pyoderma gangrenosum was suspected. Treatment with corticosteroids was started and this was successful. Pyoderma gangrenosum can mimic infectious necrotizing fasciitis. Differentiating these two conditions is important because mistreatment of pyoderma can lead to disfigurement.

A Case of Pyoderma Gangrenosum After Long Saphenous Vein Harvesting

A Case of Pyoderma Gangrenosum After Long Saphenous Vein Harvesting

A Case of Pyoderma Gangrenosum After Long Saphenous Vein Harvesting

Introduction Pyoderma gangrenosum is a rare cause of ulceration that may be confused with post-operative wound infection. Report A 74-year-old man presented with a painful ulcer after long saphenous vein harvesting. On examination, a 7 × 5 cm ulcer was noted overlying the distal end of the wound. The ulcer had a patchy necrotic base and well-demarcated violet edges with surrounding erythematous, indurated skin. Review of the clinical history revealed previous delayed wound healing. The diagnosis of pyoderma gangrenosum was confirmed by histological analysis. Discussion This case highlights the importance of the pre-operative medical history in identifying patients at risk of pyoderma gangrenosum.

A Case of Pyoderma Gangrenosum in the Nasal Root Associated with Ulcerative Colitis

We report herein on a case with pyoderma gangrenosum in the nasal root associated with ulcerative colitis. Pyoderma gangrenosum is characterized by progressive skin necrosis and is often associated with chronic bowel inflammatory diseases such as ulcerative colitis and Crohn’s disease. Although it bears a clinical resemblance to self-destructive abscesses or bacterial infection of the soft tissues, no bacteria and non-effects of antimicrobial agents were observed and the drainage of the abscess and debridement of necrotic tissue is contraindicated in patients with pyoderma gangrenosum. The treatment of the underlying disease is also effective for the treatment of pyoderma gangrenosum. In the present case, a steroid and mesalazine were effective for both the pyoderma gangrenosum and ulcerative colitis.

Pyoderma gangrenosum with renal and splenic impairment - case report

Pyoderma gangrenosum is an uncommon and recurrent neutrophilic dermatosis of unknown cause. The lesions usually start as tender sterile papulopustules or erythematous nodules that undergo necrosis followed by ulceration. The lower limbs are most commonly affected and around half of the cases are associated with systemic disorders. Although rare, cases of pyoderma gangrenosum with extramucocutaneous sterile neutrophilic infiltrate have been reported, with the lungs being the most commonly affected organ. We report a case of pyoderma gangrenosum with splenic and renal impairment. Pyoderma gangrenosum should be considered a multisystemic disease with classic cutaneous manifestations and potential involvement of internal organs.

Pyoderma gangrenosum in refractory celiac disease: a case report

BackgroundPyoderma gangrenosum is an inflammatory neutrophilic dermatosis characterized by painful cutaneous ulcerations and often associated with systemic inflammatory and neoplastic diseases. Here we report the first case of pyoderma gangrenosum in a patient with refractory celiac disease.Case presentationA 52-year-old woman with a previously diagnosed refractory celiac disease resistant to steroids and immunosuppressive drugs presented to our hospital for a rapidly growing, painful inflammatory skin lesion of the left leg. Physical examination revealed a painful lesion with focal ulceration, necrosis and pus discharge with active inflammatory borders at the external part of the left leg. Histological evaluation of a skin biopsy and analysis of inflammatory cytokines and matrix-degrading proteases in lesional skin samples confirmed the clinical suspicion of pyoderma gangrenosum. Treatment with oral prednisone was rapidly followed by a complete healing of the skin lesion but no improvement of symptoms/signs of malabsorption.ConclusionTreatment of the patient with systemic steroids healed the skin lesion without improving the underlying refractory celiac disease. This observation raises the possibility that refractory celiac disease and pyoderma gangrenosum may be immunologically different.

Genital pyoderma gangrenosum: Report of two cases and published work review of Japanese cases

Pyoderma gangrenosum is an ulcerative skin disorder showing characteristic non-infectious ulcers and affects the lower extremities in approximately 70% of cases. Pyoderma gangrenosum is commonly associated with systemic diseases such as inflammatory bowel disease, rheumatoid arthritis and hematological malignancies. Herein, we report two cases of Japanese patients diagnosed with genital pyoderma gangrenosum. Case 1 was a 74-year-old woman without associated systemic complications, whose skin lesion resembled a squamous cell carcinoma and was limited to the vulva. Case 2 is an 89-year-old man, who suffered from myelodysplastic syndrome and acute myeloid leukemia, and presented with penile and leg ulcers mimicking pressure sores. Both cases responded well to systemic steroids. We review 13 genital pyoderma gangrenosum cases (76.9% male; aged 30-89 years) from 1996 to 2012 in Japan, including 11 previously reported cases and the present study's two cases. Four of the 13 genital pyoderma gangrenosum cases had associated systemic diseases and their skin lesions spread to the extragenital areas. Eight of the remaining nine genitalia-localized pyoderma gangrenosum cases had no associated systemic diseases. In conclusion, genital pyoderma gangrenosum is rare and may be misdiagnosed. It should therefore be considered in cases of refractory genital ulcers. In addition, genitalia-localized pyoderma gangrenosum tends to be without systemic complications.

Treatment of Atypical Pyoderma Gangrenosum on the Face

Treatment of Atypical Pyoderma Gangrenosum on the Face