Granulomatose avec polyangéite révélée par une ulcération cutanée mimant un pyoderma gangrenosum : à propos de 2 cas

Cambourg, G. De; Mahé, A.; Banea, S.; Moulinas, C.; Blaison, G.

doi:10.1016/j.revmed.2015.12.010

Cited by 9 publications

(5 citation statements)

References 12 publications

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“…The presence of circulating c�ANCA, in� volvement of internal organs �especially the lungs� and lack of neutrophilic infiltration in the biopsy of skin le� sions can help to rule out and confirms the diagnosis of GPA, which simulates PG. 5,7,9,10 �hen the clinical picture of these two entities is similar, there is a problem which is both diagnostic and therapeutic. 6 Difficulties in assessing the histopathological picture such as lack of clear diagnos� tic criteria for PG and recommendation to repeat biopsy in order to determine the proper diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…6 Difficulties in assessing the histopathological picture such as lack of clear diagnos� tic criteria for PG and recommendation to repeat biopsy in order to determine the proper diagnosis. 2,5,7 Therefore, epidemiological data regarding the actual co�e�istence of PG and PGA are controversial. 9,11 Genoveese et al 9 re� viewed 28 cases and established guidelines useful for dis� tinguishing these conditions: �1� typical raised, erythema� tous�wavy edges are less visible in GPA ulcers compared to PG; (2) histology of early PG lesion consists mainly of neutrophilic inflammatory infiltrate; (3) c-ANCA positiv� ity is compatible with GPA; (4) systemic involvement is common in GPA and rare in PG.…”

Section: Discussionmentioning

confidence: 99%

“…4 Skin lesions in the course of GPA are not characteristic symptoms, but may be present in as many as 15%-50% of cases of the disease and suggest cutaneous GPA as in the case described below. 5,6 Pyoderma gangrenosum �PG� is caused by immune sys� tem dysfunction, and particularly improper functioning of neutrophils which lead to the formation of skin ulcers. Its oc� currence is estimated to be about 3-10 cases per million popu� lation per year.…”

Section: Introductionmentioning

confidence: 99%

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Granulomatosis with polyangiitis preceded with pyoderma gangrenosum in 41-year-old man

et al. 2020

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Introduction: A coexistence of pyoderma gangrenosum (PG) and granulomatosis with polyangiitis (GPA) is observed extremely rarely. Some authors believe that skin ulcers like-PG may be a cutaneous manifestation of the GPA. They highlight the difficulties in assessing the histopathological picture: lack of clear diagnostic criteria for PG and recommendation to repeat biopsy in order to determine the proper diagnosis. Aim: This article presents the case of 41-year-old man with GPA preceded with PG. Case study: We present the case of 41-year-old male with GPA (with the occurrence of bleeding into the alveoli, bleeding from the lower gastrointestinal tract and renal involvement) preceded with PG. He also had pathergy test positive. The patient was treated with cyclophosphamide and corticosteroid with improvement. Results and discussion: The presence of c-anti-neutrophil cytoplasmic antibodies (c-ANCAs) levels, despite the classic image of PG with a characteristic histology, requires special observation of patients who may develop systemic GPA. Such patients should have frequent assessments of internal organ involvement. ANCAs control is recommended since their concentrations correlate with disease activity. They may affect the re-activation and chemotaxis of neutrophils. Conclusions: The presence of c-ANCAs levels, despite the classic image of PG with a characteristic histology, requires special observation of patients who may develop systemic GPA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Granulomatosis with polyangiitis preceded with pyoderma gangrenosum in 41-year-old man

et al. 2020

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“…In addition to more commonly seen infectious processes, such as the necrotizing fasciitis (NF) and erysipelas bullosum; sporotrichosis, blastomycosis, cryptococcosis can also mimic PG. 7,27,28-42 Some inflammatory (Henoch-Schönlein purpura, 43 granulomatosis with polyangiitis 44 ); cancerous (mycosis fungoides, 45 anaplastic large-cell lymphoma 46 ); and miscellaneous (iliac vein compression syndrome, 47 bromoderma 48 ) disorders have similar presentation to PG, as well. One should also be able to set PG apart from pyogenic granuloma.…”

Section: Introductionmentioning

confidence: 99%

Postsurgical Pyoderma Gangrenosum Requiring Plastic Surgical Intervention: A Practical Review

Guliyeva,

Janis

2024

Plastic and Reconstructive Surgery - Global Open

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Summary: Pyoderma gangrenosum is a neutrophilic dermatosis characterized by immune dysfunction and pathergy. Thus, it is frequently seen in patients with underlying systemic illnesses or postoperatively. For the performance of the debridement or closure of the resultant defect, plastic surgeons are often involved in the care of pyoderma patients. However, both procedures may exacerbate the injury. Therefore, plastic surgeons must be familiar with the presentation of postsurgical pyoderma to avoid further damage and safely repair related soft tissue defects. A systematic search of the PubMed/Medline database was performed using the following keywords: “pyoderma gangrenosum” and “surgery.” This online database search has identified 656 studies published between 1958 and 2022. Only reconstructed cases of postsurgical pyoderma gangrenosum were selected. Twenty-eight patients who developed pyoderma after dermatologic, plastic, orthopedic, cardiovascular, general, or obstetric surgery were included in this study. The average time to the PG presentation and diagnosis was 5.5 and 17 days, respectively. Diagnostic scoring tools were not used, and the diagnosis was primarily based on histopathology after repeated treatment failures. The patients received split- or full-thickness skin grafts, local, pedicled, and free flaps. An estimated 82.1% underwent skin grafting, whereas 42.9% underwent flap reconstruction. In addition, 21.4% got both the graft and flap. Accurate diagnosis of PSPG, prevention of further surgical injury, and timely medical management are vital for improving patient outcomes. Reconstruction can be performed, if required. However, despite the availability of different reconstructive techniques, there is no standard approach to the management of the PSPG.

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“…Cutaneous lesions may be present at disease onset ( 12 , 13 ). Palpable purpura has been described as the most frequent skin lesion, although a wide array of clinical features may be observed ( 14 – 28 ).…”

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confidence: 99%

Cutaneous Manifestations of Granulomatosis with Polyangiitis: A Case Series Study

et al. 2020

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The aim of this study was to determine the prevalence and type of cutaneous manifestations which occur in patients with granulomatosis with polyangiitis and to explore the potential association between cutaneous and systemic involvement in these patients. A retrospective case series study was designed, including all granulomatosis with polyangiitis cases diagnosed between 2010 and 2018 at the Hospital Universitario Virgen de las Nieves. Thirty-nine patients with granulomatosis with polyangiitis were identified, of which 53.85% presented cutaneous manifestations. In decreasing order of frequency, the types of cutaneous problems observed included: palpable purpura, mucocutaneous ulcers, subcutaneous nodules, pyoderma gangrenosum-like ulcers, digital necrosis, papulonecrotic lesions and livedo reticularis. Patients with palpable purpura presented a higher frequency of renal involvement ( p = 0.008). Cutaneous manifestations of granulomatosis with polyangiitis may facilitate early disease diagnosis. Likewise, a manifestation such as palpable purpura may be a predictor of kidney damage.

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Granulomatose avec polyangéite révélée par une ulcération cutanée mimant un pyoderma gangrenosum : à propos de 2 cas

Cited by 9 publications

References 12 publications

Granulomatosis with polyangiitis preceded with pyoderma gangrenosum in 41-year-old man

Granulomatosis with polyangiitis preceded with pyoderma gangrenosum in 41-year-old man

Postsurgical Pyoderma Gangrenosum Requiring Plastic Surgical Intervention: A Practical Review

Cutaneous Manifestations of Granulomatosis with Polyangiitis: A Case Series Study

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