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Results for “Pyoderma Gangrenosum”

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PubMed1996

Acute form of pyoderma gangrenosum induced by traumatic injury.

A 45-year-old man with the acute form of pyoderma gangrenosum is reported. He developed characteristic ulcers that rapidly followed violaceous erythema at sites of traumatic injury. The skin lesions repeatedly appeared six times within 7 years. Each time, the skin lesions were localized to sites of trauma, and no systemic symptoms nor abnormal laboratory findings were associated. Histological findings were acute superficial inflammation with neutrophilic infiltration into the dermis. Sweet's syndrome-like skin lesions were once associated, indicating that pyoderma gangrenosum and Sweet's syndrome have a close relationship. Nonsteroidal antiinflammatory drugs, potassium iodide, and minocycline were not effective. He was successfully treated with oral administration of corticosteroid. The pathergy of this patient must have been caused not only by the trauma itself but by additional factors such as epidermal components or contaminating micro-organisms, since traumatic injury did not always cause the skin lesions.

Acute Disease↗
PubMed2001

A rationale for adjuvant surgical intervention in pyoderma gangrenosum.

Medical specialists who care for patients with pyoderma gangrenosum have been reluctant traditionally to consult plastic surgeons. This is the result of previous negative experience with debridement and skin grafting. However, a new understanding of the pathophysiology of the disease process, and better therapeutic options for control have emerged. Very few studies report the results of surgical therapy of this disease, and fewer yet report successful outcome. The authors present their limited experience at the American University of Beirut with 4 patients who were controlled medically followed by skin grafting their large wounds, thus decreasing their morbidity and hospital stay. A review of the literature together with insights on the rationale and timing of surgery in this particular small group of patients are discussed.

Adolescent↗
PubMed2002

Parastomal pyoderma gangrenosum: a case report and literature review.

Parastomal pyoderma gangrenosum (PPG) is an exceedingly rare disease process most often observed in inflammatory bowel disease patients with an ileostomy. Fewer than 50 cases have been reported in the medical literature. The incidence is 0.6 per cent of patients with ileostomy and inflammatory bowel disease. The rarity of the disease leads to misdiagnosis and mistreatment of the lesion. The intense pain and disruption of ostomy function greatly impair affected individuals beyond the limit of their underlying disease. Current best care practices observed in small study series indicate long-term intensive medical therapy aimed at systemic disease suppression to optimize PPG wound healing. Our patient had no signs of active Crohn disease at the time of PPG presentation. She was initially treated with minimal wound debridement and intralesional triamcinolone. Finally under the care of an enterostomal/wound care therapist the patient achieved excellent PPG resolution in 6 months.

Adult↗
PubMed1991

Sporotrichosis presenting as pyoderma gangrenosum.

A 56-year-old female with an eight-year history of corticosteroid therapy for rheumatoid arthritis presented with large, deep, painful ulcers on the left buttock and thigh. The lesions appeared typical of pyoderma gangrenosum. Nine separate cultures of the exudate grew Sporothrix schenckii. During the course of iodide therapy, the patient expired due to Escherichia coli pneumonia. This is the third case report of sporotrichosis presenting as pyoderma gangrenosum and the first report from China. Sporotrichosis presenting as pyoderma gangrenosum is a special form of this disease. It develops quickly and must be treated promptly. Only two cases have been reported in the world literature. This is the first case reported from China.

Biopsy↗
PubMed1984

Pyoderma gangrenosum and ulcerative colitis in black South Africans. Case reports.

Two patients with pyoderma gangrenosum and ulcerative colitis are described. To our knowledge this is the first report of such an association in Blacks. The unusual vesicopustular form of pyoderma gangrenosum was well demonstrated by one patient who also responded remarkably to clofazimine. The associations, pathological findings and therapy are briefly reviewed. Colectomy may ameliorate the skin lesions when conventional therapy is unsuccessful.

Adolescent↗
PubMed1994

Pyoderma gangrenosum complicated by necrotizing fasciitis.

Necrotizing fasciitis is a potentially life-threatening infection that may resemble extensive pyoderma gangrenosum. The treatment of the two diseases is, however, different, and differentiating them is therefore essential. A case is presented in which necrotizing fasciitis appeared as a complication of pyoderma gangrenosum. The successful treatment is described, and the differential diagnosis of the two entities is presented. The need for early and aggressive treatment of necrotizing fasciitis is stressed.

Aged↗
PubMed2003

Pyoderma gangrenosum in a thoracotomy wound associated with a pulmonary cavitating lesion.

We present a patient with both pyoderma gangrenosum in a thoracotomy wound and a pulmonary cavitating lesion with the histological features of Wegener's granulomatosis. An ulcer with blue undermined edges developed in our patient's thoracotomy scar after a lobectomy was carried out for the cavitating lung lesion and c Antineutrophil Cytoplasmic Antibodies (cANCA), which is highly specific for active Wegener's granulomatosis but was negative at the time of her skin lesion. This suggests that our patient had cutaneous pyoderma gangrenosum rather than cutaneous Wegener's granulomatosis, although the two conditions may occasionally have similar clinical and histological features.

Aged↗
PubMed1995

Pyoderma gangrenosum and sterile multifocal osteomyelitis preceding the appearance of Takayasu arteritis.

A 9-month-old infant had pyoderma gangrenosum (PG) and sterile osteomyelitis. Three years later the patient developed Takayasu arteritis (TA). Sterile osteomyelitis was reported in approximately 30 patients with different skin lesions, but never together with pyoderma gangrenosum. The association of PG and TA has been reported rarely, and then mainly in adults or in children over age 9 years. This rare association should alert physicians with a case of infantile PG of unknown etiology to consider the possible diagnosis of TA.

Dose-Response Relationship, Drug↗
PubMed1984

Treatment of pyoderma gangrenosum with disodium cromoglycate.

The case of a 35-year-old black woman with a 10-year history of ulcerative colitis and a 3-year history of pyoderma gangrenosum is presented. The pyoderma gangrenosum was treated successfully with topical application of disodium cromoglycate.

Administration, Topical↗
PubMed1979

[Pyoderma gangrenosum, ovarian carcinoma treated with Melphalan and acute myelomonocytic leukaemia: report of one case and literature review (author's transl)].

A 67-year-old woman suffered from an ovarian carcinoma with lymph nodes metastasis. During 3 years, she was treated with alkylating agents (Melphalan). At the end of therapy, no recurrence was observed. Two years later, she developed concomitantly pyoderma gangrenosum and acute myelomonocytic leukaemia. Death occurred rapidly. The association between pyoderma gangrenosum and acute leukaemia is discussed in the light of 16 cases previously reported in the literature. In this case, an induction of leukaemia by cytostatic drugs seems likely. The authors conclude that pyoderma gangrenosum may be considered as a cutaneous signs of acute leukaemia.

Aged↗
PubMed1983

Does intestinal resection heal the pyoderma gangrenosum of inflammatory bowel disease?

A retrospective study of nine patients with active pyoderma gangrenosum at the time of operation for inflammatory bowel disease showed two patterns of postoperative skin healing: 1) prompt healing within 2 months, occurred in five patients with moderate to severe inflammatory bowel disease. 2) skin disease persisted in four others, healing only after a year. Three of these patients had mild ulcerative colitis, and in them, the operation was carried out in the hope of curing crippling pyoderma gangrenosum. The fourth patient had only an intestinal bypass for ileitis. Our observations suggest that prompt skin healing may occur after surgery in patients with severe inflammatory bowel disease, but not necessarily in those with milder bowel disease or in those in whom some bowel disease persists.

Adolescent↗
PubMed2002

[A case of pyoderma gangrenosum involving the prostate gland after radiation therapy for prostate cancer].

A 76-year-old man complained of difficulty in urination and miction pain with abacterial pyuria after radiation therapy for prostate cancer. Transurethral resection of the prostate was performed and histopathologically widespread necrosis was observed in the prostate. Thereafter retention of urine and fever occurred and computed tomography scan revealed an abscess of the penile corpus. The abscess was drained, but the fever continued. He developed an abacterial lung abscess and abacterial necrotic ulcerating lesions on his back, his left leg and his lower abdomen. Macroscopic findings demonstrated typical features of pyoderma gangrenosum. Steroid treatment was initiated and the response to steroid therapy was dramatic. Finally urinary diversion using an ileal conduit was performed. We found few cases of pyoderma gangrenosum involving lesions other than those of the skin in the literature. This is the first report of pyoderma gangrenosum involving the prostate gland after radiation therapy for prostate cancer.

Aged↗
PubMedDate not supplied

[Pyoderma gangrenosum and chronic myeloïd leukemia. Two new cases (author's transl)].

Two new cases of pyoderma gangrenosum with chronic myeloid leukemia are described and added to three others of the literature. Pyoderma gangrenosum is often bullous, painful and progresses quickly. It seems to have a bad prognosis in myeloid leukemia as in polycythemia vera, in which it appears lately as an evolution to myelofibrosis or acute leukemia transformation. Chemotactic disorders of polynuclear may be the main etiological factor in these cases.

Adult↗
PubMed1992

Pyoderma gangrenosum--response to topical nitrogen mustard.

We report a 69-year-old caucasian male patient with long-standing pyoderma gangrenosum; the lesions preceded the appearance of an IgA monoclonal gammopathy by 2 years. A number of systemic treatments, including high dose steroids and immunosuppressive agents, were poorly tolerated and resulted in serious side-effects. The skin and haematological conditions, however, were kept under control for 2 years with regular plasmapheresis. Pyoderma gangrenosum recurred as vascular access became exhausted but new lesions healed completely with topical application of 20% nitrogen mustard.

Administration, Topical↗
PubMed1987

Pyoderma gangrenosum in a kindred. Precipitation by surgery or mild physical trauma.

Five cases of pyoderma gangrenosum occurring in a kindred are presented. Three of the cases occurred after abdominal surgery and tended to be confused with postoperative wound infections. Two cases occurred after superficial injury to the leg and were also thought to represent a peculiar form of cellulitis. None of the patients are known to have any of the underlying diseases usually associated with pyoderma gangrenosum. The cases are presented to alert the physician to this entity and to document the unusual familial occurrence.

Abdomen↗
PubMed1987

Pyoderma gangrenosum occurring at multiple surgical incision sites.

Ten weeks after subtotal colectomy and ileostomy for ulcerative colitis, a 16-yr-old girl developed wound drainage and back pain. Massive ulceration and skin separation occurred at the abdominal wound incision as well as at the incision sites of a previous central venous line. A diagnosis of pyoderma gangrenosum was made. High-dose steroid treatment induced prompt healing of the abdominal wound as well as the catheter sites. Pyoderma gangrenosum has rarely been seen in surgical wounds. To our knowledge, this is the first reported case of pyoderma gangrenosum occurring simultaneously in multiple surgical incision sites in a patient with ulcerative colitis.

Adolescent↗