Phagedenic and Gangrenous Ulceration of the Skin Complicating Ulcerative Colitis (Phagedena Geometricum)

Russell, Madeline

doi:10.1111/j.1365-2133.1950.tb10964.x

Cited by 22 publications

(5 citation statements)

References 21 publications

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“…There have been occasional reports of erythema nodosum preceding the colitis (Fernandez-Herlihy, 1959;Edwards and Truelove, 1964) but we did not see such a case. Ulceration of the nodules does not normally occur but has previously been reported in patients suffering from ulcerative colitis (Russell 1950;Kelley and Logan, 1956). In one of our patients several nodes in front of the shins broke down and ulcerated but healed rapidly after colectomy.…”

Section: Discussionmentioning

confidence: 88%

Skin lesions in ulcerative colitis.

Johnson¹,

Wilson²

1969

Gut

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This paper is a study of the skin complications of ulcerative colitis. Between theyearsl949and 1965,415 patients, 230 women and 185 men, were admitted to the Central Middlesex Hospital suffering from this disease. Our object has been to determine the incidence and pattern of the skin disorders in this group and to try to discover if there is any relationship between the skin disease and the severity and extent of the colitis. Twenty patients had dermatoses associated with the bowel disorder and 12 were examined by one of us (H.T.H.W.). The morphological classification is based on these personally observed cases. The sex incidence showed that whereas 55 % of the whole series of colitics were women, 14 (70%) of those who had skin complications were women. Seven developed different types of lesion at different stages of the disease. The main conditions found were erythema nodosum (eight cases), pyoderma gangrenosum (seven cases), papulo-necrotic lesions (five cases), and ulcerating erythematous plaques on the shins (three cases). ERYTHEMA NODOSUMTender red nodes, generally appearing on the shins and associated with exacerbations of the colitis, occurred in eight patients, all women.The age of onset of erythema nodosum varied from 21 to 52 years (mean 29 years) and the skin lesions developed at any time from the onset of the first attack of colitis to 16 years later (mean 5*5 years). Although the attacks of erythema nodosum coincided with exacerbations of the colitis there was no correlation with the extent of the disease.

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Section: Discussionmentioning

confidence: 88%

Skin lesions in ulcerative colitis.

Johnson¹,

Wilson²

1969

Gut

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“…When associated with ulcerative colitis, the disease activity of pyoderma gangrenosum may parallel that of the bowel disease: the control of the intestinal condition can resolve the skin problem and recurrences may occur at periods of exacerbation of IBD. However, skin lesions may also have an evolution that is partially independent of the intestinal activity of IBD, and while some authors suggest a relationship between exacerbations of the colitis and the onset of skin disorder, 23,24 others have found no correlation 25,26 . In some patients with IBD and pyoderma gangrenosum, a trauma may be a common precipitating factor without any association with clinical exacerbation of disease.…”

Section: Course and Prognosismentioning

confidence: 99%

Pyoderma gangrenosum: an updated review

Ruocco¹,

Sangiuliano²,

Gravina

et al. 2009

Journal of the European Academy of Dermatology and Venereology

426

521

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Pyoderma gangrenosum is a rare, ulcerative, cutaneous condition. First described in 1930, the pathogenesis of pyoderma gangrenosum remains unknown, but it is probably related to a hyperergic reaction. There are various clinical and histological variants of this disorder. Pyoderma gangrenosum often occurs in association with a systemic disease such as inflammatory bowel disease, rheumatologic disease, paraproteinaemia, or haematological malignancy. The diagnosis, mainly based on the clinical presentation and course, is confirmed through a process of elimination of other causes of cutaneous ulcers. Local treatment may be sufficient for mild disease, while for severe cases, systemic immunosuppressants are the mainstay. Long-term treatment with these agents is often required, but this can expose patients to adverse side-effects.

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“…(a) The simultaneous im provem ent and relapse of sym ptom s of colitis ulcerosa and pyoderma gangraenosum and sometimes of ar thritis as well is mentioned for at least 34 of the 53 patients of the first group [51,11,13,48,73,30,17,12,32,20,70,61,55,54,15,45,27,41,39,71].…”

mentioning

confidence: 99%

“…One group, of 10 patients, had various intestinal disorders (one of them suffered from ileitis rcgionalis [24,49,26,4,16,31,40,29,61].…”

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confidence: 99%