Co-Existence of Pyoderma Gangrenosum and Hidradenitis Suppurativa: Case Report

Abstract

yoderma gangrenosum (PG) is a rarely seen idiopathic neutrophilic dermatosis characterized by destructive cutaneous ulceration and sometimes accompanied by other cutaneous and systemic diseases. It was described for the first time by Brusting et al. in 1930. 1,2 Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disorder accompanied by subcutaneous nodules. 3In this study, a case of a female patient with pyoderma gangrenosum developing on hidradenitis suppurativa is presented. The patient showed a dramatic response to cyclosporin and systemic corticosteroid treatment. Co-Existence of Pyoderma Gangrenosum and Hidradenitis Suppurativa: Case Report A AB BS ST TR RA AC CT T Although the cause of pyoderma gangrenosum is not known exactly, abnormal neutrophil chemotaxis is considered to be responsible primarily. Neutrophilic dermatose is described as a multisystemic disease and it is also associated with inflammatory bowel disease, hidradenitis suppurativa, rheumatoid arthritis, hematological malignities and monoclonal immunoglobulin A gammopathies in addition to skin involvement. Hidradenitis suppurativa together with pyoderma gangrenosum was rarely reported and no correlation was determined between severity and association of two diseases in reported cases. High dose oral corticosteroid, cyclosporin, intravenous immunoglobulin and intravenous cyclophosphamide are reported among therapy options in severe cases. Here, 63-years old female patient with pyoderma gangrenosum developing in the hidradenitis suppurativa and responding to cyclosporin and systemic corticosteroid treatment dramatically was presented.K Ke ey y W Wo or rd ds s: : Hidradenitis suppurativa; pyoderma gangrenosum Ö ÖZ ZE ET T Piyoderma gangrenosum nötrofil kemotaksis bozukluğunun sorumlu olduğu, nedeni tam olarak bilinmeyen bir hastalıktır. Nötrofilik dermatozlar multisistemik bir grup hastalık olup, deri tutulumuna ek olarak, inflamatuar barsak hastalığı, hidradenitis süpürativa, romatoid artrit, hematolojik maligniteler ve immunglobulin A gamopatisi ile de birlikte olabilir. Hidradenitis süpürativa ve piyoderma gangrenosum birlikteliği nadir olarak bildirilmiştir ve bildirilen olgularda hastalığın ciddiyeti ile iki hastalık arasında korelasyon saptanmamıştır. Ciddi olgularda yüksek doz sistemik steroidler, siklosporin, intravenöz immünglobulin ve intravenöz siklofosfamid tedavisi verilmektedir. Burada 63 yaşında hidradenitis süpürativa ve piyoderma gangrenosumun beraber olduğu, sistemik steroid ve siklosporine dramatik yanıt alınan kadın hasta sunulmaktadır.A An na ah ht ta ar r K Ke el li im me el le er r: : Hidradenit süpüratif; piyoderma gangrenozum T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J C Ca as se e R Re ep p 2 20 01 15 5; ;2 23 3( (3 3) ): :3 31 13 3--7 7