Pyoderma Research Articles

A case of ulcerative colitis complicated by pyoderma gangrenosum treated with mesalazine

A case of ulcerative colitis complicated by pyoderma gangrenosum treated with mesalazine

Diagnosis and treatment of painful leg ulcers

Painful leg ulcers are very common in clinic, including arterial ulcers, venous ulcers, autoimmune diseases-related ulcers, gangrenous pyoderma, necrobiosis lipoidica and hypertensive ulcers. At present, few painful leg ulcer-related researches have been conducted in China, and pain is only treated as a concomitant symptom of leg ulcers. However, a series of painful leg ulcer-related researches have been carried out in other countries. This review comprehensively expounds the definition, epidemiological characteristics, etiology and management of, as well as pain mechanism and assessment in painful leg ulcers. Key words: Leg ulcer; Pain; Pain management; Therapy

Extraintestinal manifestations and characteristics of ulcerative colitis in Xinjiang Uygur Autonomous Region

Objective To analyze the extraintestinal manifestations and clinical characteristics of patients with ulcerative colitis (UC) and to improve the knowledge, diagnosis and treatment of UC with extraintestinal manifestations. Methods From January 2013 to December 2017, at the Department of Gastroenterology, People′s Hospital of Xinjiang Uygur Autonomous Region, 260 hospitalized patients diagnosed as UC were collected. The demographic characteristics, clinical phenotypes and extraintestinal manifestations were analyzed. Chi square test was used for statistical analysis. Results Among 260 UC patients, 41.9% (109/260) had extraintestinal manifestations, including fatty liver (17.3%, 45/260), gallbladder stone (11.9%, 31/260), typeⅠperipheral arthritis (8.1%, 21/260), type Ⅱ peripheral arthritis (3.1%, 8/260), oral ulcer (4.6%, 12/260), erythema nodosum (3.8%, 10/260), irireitis (1.9%, 5/260), ankylosing spondylitis (1.5%, 4/260), sacroiliitis (1.5%, 4/260), pyoderma gangrenosum (0.4%, 1/260) and primary sclerosing cholangitis (0.4%, 1/260). Gender, ethnicity, age, history of intestinal surgery and body mass index (BMI) could affect the occurrence of extraintestinal manifestations in patients with UC (χ2=7.901, 4.318, 9.291, 8.162 and 10.397, all P<0.05). The incidence of joint lesions in Uygur UC patients was higher than that in Han UC patients (16.6%, 24/145 vs. 7.0%, 8/115), and the difference was statistically significant ( χ2=5.471, P=0.019). The incidence of extraintestinal manifestations in UC patients in the active phase was higher than that of UC patients in the inactive phase (52.9%, 92/174 vs. 19.8%, 17/86), and the difference was statistically significant (χ2=25.908, P<0.01). Conclusions UC is complicated with a variety of extraintestinal manifestations. The most commonly involved organs are liver and gallbladder, joint and oral cavity. The extraintestinal manifestations are more common in female, Uygur, patients with high BMI, youth, patients with a history of intestinal surgery and UC patients at the active phase. Key words: Colitis, ulcerative; Extra-intestinal manifestations; Clinical features

Effective New Therapy for Pyoderma Gangrenosum

Pyoderma gangrenosum affects patients with inflammatory bowel disease (IBD); few effective treatments are available. Investigators at the University of

Опыт применения препарата Инфликсимаб (Фламмэгис) в лечение гангренозной пиодермии при язвенном колите (клинический случай).

Опыт применения препарата Инфликсимаб (Фламмэгис) в лечение гангренозной пиодермии при язвенном колите (клинический случай).

Pyoderma Gangrenosum — A Large Case Series

Although pyoderma gangrenosum is uncommon, busy generalist clinicians likely will encounter cases of this ulcerating cutaneous disorder on occasion. In

A case of pyoderma gangrenosum on the abdomen after surgical excision of gastric stromal tumor

A case of pyoderma gangrenosum on the abdomen after surgical excision of gastric stromal tumor

Hidradenitis Suppurativa: Inside and Out.

Hidradenitis suppurativa is a chronic, disabling, suppurative disease characterized by deep tender subcutaneous nodules; complicated by fibrosis and extensive sinuses affecting primarily the apocrine gland bearing areas. It affects all races in early 20s with greater prevalence seen in women (3 to 5:1). The estimated disease prevalence is 1 - 4 %. The disease is speculated to be caused by follicular structural abnormalities with associated risk factors as smoking, obesity, positive family history and shaving. Certain co-morbidities can also be seen such as inflammatory bowel disease, spondyloarthropathies, epithelial tumors, pyoderma gangrenosum etc. Treatment modalities include counseling of the patient to lose weight if obese, to wear loose clothes, stop smoking and maintain good hygiene. Topical antibiotics, like 1% clindamycin, have shown to give good results along with benzoyl peroxide wash. Orally cocktail of antibiotics can be given, though biologicals remain the best treatment option. Surgical excision can be done in later stages and in recalcitrant cases.

Clinical analysis of eight cases of ulcerative colitis complicated by pyoderma gangrenosum

Objective To investigate clinical manifestations, histopathological features and treatment of ulcerative colitis (UC) complicated by pyoderma gangrenosum (PG) . Methods Data on clinical manifestations, auxiliary examination findings, treatment and prognosis were collected from 8 inpatients with UC complicated by PG in Peking Union Medical College Hospital between July 2009 and July 2016, and analyzed retrospectively. Results Of the 8 cases, 5 were male, and 3 were female. The average age of onset was 30.6 years and 35.1 years in males and females respectively. All the patients developed intestinal symptoms of UC before the onset of PG with an average time interval of 5 years. Moreover, all the patients had active total colonic type UC at the onset of PG, including 6 with moderately active UC and 2 with mildly active UC. PG manifested as painful ulcers in 8 patients, and affected lower limbs in 7 patients. Histopathological examination of skin lesions showed typical characteristics of vasculitis in 5 patients. Five patients were complicated by arthralgia. All the patients were treated with glucocorticoids and 5-aminosalicylic acid agents as the basic therapy, 3 patients received extra treatment with immuno-suppressive agents or minocycline, and 2 with infliximab. Conclusions PG is a severe skin manifestation of UC, commonly occurs in patients with total colonic type UC in the active stage, and mostly affects the lower limbs, with typical histopathological features of vasculitis. Key words: Pyoderma gangrenosum; Colitis, ulcerative; Disease attributes; Treatment outcome; Inflammatory bowel disease

A case of repeatedly misdiagnosed pyoderma gangrenosum in childhood

A case of repeatedly misdiagnosed pyoderma gangrenosum in childhood

Hyperbaric oxygen for the treatment of skin diseases

Hyperbaric oxygen (HBO) therapy is the inhalation of 100% oxygen at a pressure higher than one atmosphere absolute (ATA) , and has been used as an auxiliary therapy for various skin diseases. It has been proved that HBO can increase the oxygen content in skin tissues, accelerate aerobic metabolism of skin, promote epithelial regeneration and wound healing, relieve adverse stimuli on peripheral nerves and sensors in the skin, inhibit apoptosis of neurons, enhance the function of regulatory T cells, alleviate inflammation, and mobilize vascular stem/progenitor cells (SPCs) from the bone marrow to peripheral blood and ulcer tissues. At present, HBO has been widely applied in the auxiliary treatment of psoriasis, atopic dermatitis, postherpetic neuralgia, chronic refractory cutaneous ulcer, pyoderma gangrenosum, fungal infection, vascular embolization after cosmetic facial filling, and some other skin diseases. Key words: Skin diseases; Hyperbaric oxygenation; Therapeutic uses; Drug therapy, combination; Physical therapy modalities

Multiple pulmonary cavitary nodules with pyoderma gangrenosum in patient with rheumatoid arthritis.

Pyoderma gangrenosum (PG) is a rare ulcerative neutrophilic disorder of skin. Its pulmonary manifestations are uncommon and only less than forty cases have been reported in the literature previously. PG is associated with variable systemic diseases, most commonly inflammatory bowel disease and hematologic malignancies. It reported rarely in rheumatoid arthritis (RA). We report a case of PG lung involvement in patient with RA associated interstitial lung disease. A 66-year-old woman presented with productive cough and recurrent ulcerative lesion on her left ankle. She had a 15-year history of RA associated interstitial lung disease and treated with methotrexate, sulfasalazine, hydroxychloroquine and methylprednisolone. On physical examination, there were a few tender, erythematous subcutaneous nodules ranging from 1 to 3 cm in diameter on her left thigh and left elbow. Anti-neutrophil cytoplasmic antibodies (ANCAs) are negative. Her chest CT scan demonstrated multifocal cavitary consolidations on the background of reticular opacity and honeycombing. Punch biopsy of erythematous nodule on thigh showed neutrophilic abscess with necrotic debris. The skin and lung lesions were rapidly improved with 0.5 mg/kg/day of prednisolone.

Canakinumab Might Be Effective for Pyoderma Gangrenosum

Pyoderma gangrenosum (PG), a rare inflammatory ulceration of the skin, has an unknown pathogenesis, but a variety of inflammatory mediators seem to

Treatment of Pyoderma Gangrenosum — Is Prednisolone or Cyclosporine Best?

Pyoderma gangrenosum, an ulcerative disease of unknown etiology, is associated with underlying disease, primarily inflammatory bowel disease and

A Case of Multiple Pulmonary Nodules in Association With Pyoderma Gangrenosum

This report describes a patient with pyoderma gangrenosum (PG), in whom there were co-existent lung abnormalities. The patient’s CT scan showed peripherally sited multiple pulmonary lesions bilaterally. A lung biopsy showed chronic non-specific inflammatory changes with neutrophil and lymphocyte infiltration which were similar to the skin lesions. This case was diagnosed as multiple aseptic nodules in PG. The pulmonary infiltrative shadows were controlled only with prednisolone treatment. Steroid therapy is considered to be the first choice to control pulmonary lesions of this disease. The main differential diagnosis in these cases is Wegener granulomatosis (WG). J Med Cases. 2015;6(2):84-86 doi: https://doi.org/10.14740/jmc2072e

Pyoderma gangrenosum associated with Behçet's Disease: A Case Report

Pyoderma Gangrenosum (PG) genellikle orta yastaki eris- kinleri etkileyen, nadir gorulen, notrofilik inflamatuvar bir deri hastaligidir. Etyolojisi ve patogenezi net olarak bilin- memektedir. Behcet hastaligi (BH) ise multisistemik bir vaskulit olup, deri bulgulari arasinda nadiren PG da goru- lebilmektedir. On uc yildir BH oykusu olan, 29 yasindaki bir erkek hasta sol bacakta ulserle poliklinigimize basvurdu. Dermatolojik muayenesinde sol alt bacakta en buyugu 12x6 cm olan, fasyaya kadar uzanan derin, hafif purulan akinti ve kotu kokunun eslik ettigi 3 adet ulser saptanan hastadan yapi- lan histopatolojik inceleme PG ile uyumluydu. Burada agresif seyirli bir BH'da gorulen PG lezyonlarinin kontrolunun saglanmasi icin, sistemik tedavinin uzun sure ve kombine yapilmasi gerekebilecegini vurgulanmak ama- ciyla sunulmustur. Pyoderma gangrenosum (PG),is a rare neutrophilic inflam- matory skin disease, usually affecting middle-aged adults. The etiology and pathogenesis is not clear. Behcet's disease (BD) is a multisystem vasculitis, in which PG can rarely be seen among its cutaneous manifestations., A 29 -year-old male patient with a 13 years history of BH, was admitted to clinic with left leg ulcers. On dermatologi- cal examination 3 ulcers localized on the left lower leg, with the largest one being 12x6 cm, spreading to the deep fas- cia, accompanied by mild purulent discharge and bad smell. The histologically was compatible with PG. This report is presented to emphasize the necessity of long term and combined treatment of PG accompanying BD with agressive course

Bioautography screening of Jatropha gossypsifolia L. Leaves against the Gram positive organisms

Jatropha gossypifolia L ., belonging to the family Euphorbiaceae is traditionally used in curing various ailments. It is commonly called as cotton leaf, physic nut and Belly ache. In Tamil commonly called as Kattamanakku. Humans are natural hosts for many bacterial species that colonize the skin as normal flora. Staphylococcus aureus and Streptococcus epidermis is infrequent resident flora, but they account for a wide variety of bacterial pyodermas. Predisposing factors to infection include minor trauma, pre-existing skin disease, poor hygiene, and rarely, impaired host immunity. The present study deals with the antibacterial activity and phytochemical screening of Jatropha gossypifolia . Sequential extraction was carried out using solvents such as chloroform, ethanol, and water from leaf of the plant were investigated for preliminary phytochemical and antibacterial property. Results of the study showed that all the extracts had good inhibitory activity against Gram-positive test organism. Although all four extracts showed promising antibacterial activity against test bacterial species, yet maximum activity was observed in ethanol extract. The minimum inhibitory concentration ranged in between 64 to 1024 ? g/ml. Evaluation of phytochemicals such as alkaloids, flavonoids, saponin, tannin, glycosides, phenolic compound, proteins and amino acids revealed the presence of most of constituents in polar extracts of aqueous. All the findings exhibit that the leaf extracts have broad-spectrum activity and suggest its possible use in treatment of infectious diseases.

Bacterial Pyodermas in Dogs

 Due to the fact that pyodermas are wide spread and sometimes hard to diagnose and control, updating the data found in the scientific literature allows correct identification of the causes which are at the base of the occurrence of the infectious process and implementation of an efficient therapeutic management, making prevention possible. In order to diagnose and obtain optimal results, the following must be done: a complete medical history, a detailed clinical exam, cutaneous cytology exams, antibiogram bacteriologic exam, and, if necessary, a histopathological exam. Staphylococcus pseudintermedius is the etiological agent involved in the majority of pyoderma cases. Recent studies have shown that, although pyodermas are classified as primary and secondary, depending on the generation process, secondary pyodermas have a higher occurrence rate in practice. Primary pyodermas are considered to be idiopathic. Therefore, treating the primary conditions which cause their occurrence, represents the guarantee in avoiding a relapse. Literature data claim that pyoderma treatment is done according to the depth of the infectious process, using an exclusively local treatment or a combined one: systemic and topical. In the worst cases, the auto vaccine represents a solution against relapses. The knowledge of the pathogenetic process, of the clinical panel and the importance of using specific complementary exams, allow a therapeutic approach which is appropriate to the infectious process, as well as treatment cost reduction.

Temporary renal insufficiency associated with topical tacrolimus treatment of multilocal pyoderma gangrenosum

Prof. Dr. U. Wollina, Department of Dematology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt,Freidrichstrasse 41, 01067 Dresden, Germany. E-mail: wollina-uw@khdf.deIn renal transplant patients maintenance therapy with lowdose tacrolimus and mycophenolate mofetil in combinationis used to prevent renal injury and graft rejection.

Mycophenolate Mofetil Is Effective as a Steroid-Sparing Agent for Pyoderma Gangrenosum

Pyoderma gangrenosum (PG) is relatively uncommon, and its successful treatment is often challenging. Mycophenolate mofetil (MMF) has sometimes been