Present status of pyoderma gangrenosum. Review of 21 cases

Prystowsky, Janet H.

doi:10.1001/archderm.125.1.57

Cited by 67 publications

(64 citation statements)

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“…High-dose intravenous steroid pulse therapy is recommended for refractory cases [47]. Prystowsky et al [48] noted good clinical results in 6 of 8 PG patients treated with methylprednisolone over 3–5 days.…”

Section: Treatmentmentioning

confidence: 99%

Extraintestinal Manifestations of Crohn’s Disease

et al. 2005

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In each case of extraintestinal manifestations of Crohn’s disease, active disease, if present, should be treated to induce remission, which may positively influence the course of most concomitant extraintestinal manifestations. For some extraintestinal manifestations, however, a specific treatment should be introduced. This latter part of disease management will be discussed in this chapter, in particular for pyoderma gangrenosum, uveitis, spondylarthropathy – axial arthropathy – and primarysclerosing cholangitis, which have also been described in quiescent Crohn’s disease. Few new drugs for the treatment of extraintestinal manifestations of Crohn’s disease have been developed in the past and only the role of infliximab has increased in Crohn’s disease-related extraintestinal manifestations. Drugs specifically aimed at this treatment, stemming from a few randomized controlled studies or case series, are sulfasalazine, 5-ASA, corticosteroids, azathioprine or 6-mercaptopurine, methotrexate, infliximab, dapsone and cyclosporine or tacrolimus.

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Section: Treatmentmentioning

confidence: 99%

Extraintestinal Manifestations of Crohn’s Disease

et al. 2005

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“…The last form of PG, the superficial granulomatous form, has a minimal neutrophilic infiltration and has a less severe course. It has been described in patients with Wegener's disease, and usually follows traumatisms and thoracic surgery (8)(9)(10). Pyostomatosis vegetans is a variety of PG localized in the oral mucosa and is normally associated with IBD.…”

Section: Discussionmentioning

confidence: 99%

Atypical pyoderma gangrenosum in inflammatory bowel disease: A severe diagnostic challenge

Muñoz

Ugidos

Montiel

et al. 2009

Rev. esp. enferm. dig.

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Pyoderma gangrenosum (PG) is a rare inflammatory and ulcerative disease of the skin of unknown etiology. Diagnosis of PG is based on clinical and histological data and requires the exclusion of other ulcerative diseases of the skin. There is an atypical form of PG that appears generally associated with hematological malignancies and rarely has been described in patients with inflammatory bowel disease (IBD). We describe the case of a patient diagnosed with IBD in whom symptomatology was mainly extraintestinal as atypical PG. Case reportA 39-year-old man was referred to our hospital complaining of diarrhea consisting in passage of six to eight liquid stools containing mucus and small amounts of blood each day. One year before, he had been diagnosed of IBD, likely ulcerative colitis, and was treated with corticosteroids and topical 5-aminosalicilates. At the time of hospitalization, in addition to diarrhea, he showed fever (38 ºC), anemia, leukocytosis and elevated reactive C protein serum levels (20.4 ng/mL). Physical examination revealed the presence of a perianal fistula. The colonoscopy demonstrated hyperemia, edema, friability, and granularity, as well as pinpoint ulceration of the colonic mucosa. These changes were diffuse and extended from the rectum throughout the left colon. Histologicaly, it displayed changes consistent with IBD. The patient was treated with high

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“…Prystowsky i wsp. przedstawiają wyleczenie w 6 na 8 przypadków PG w czasie 5,5 miesiąca przy zastosowaniu ogólnie GKS w monoterapii [12]. Nasze wieloletnie doświad-czenia terapii PG u kilkudziesięciu chorych, poparte przedstawionymi przypadkami, nie potwierdzają skuteczności monoterapii GKS, zwłaszcza w osią-gnięciu wyleczenia lub uzyskaniu długotrwałej remisji.…”

Section: Przypadekunclassified

Pyoderma gangrenosum, diagnostic and therapeutic difficulties – two cases imitating breast cancer

Tupikowska¹,

Kaniowski²,

Gruber³

et al. 2016

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Przegląd Dermatologiczny 2016/1 StreSzczenieWprowadzenie. Piodermia zgorzelinowa jest rzadką dermatozą o nieznanej etiologii. Zmiany skórne to szybko szerzące się, bolesne, niegoją-ce się owrzodzenia z martwiczym dnem i wałowatym brzegiem. Cel pracy. Opis dwóch chorych z piodermią zgorzelinową imitującą raka piersi i ich leczenia. Opis przypadków. U dwóch pacjentek z podejrzeniem raka piersi po zabiegu usunięcia guzków powstały niegojące się i bolesne owrzodzenia. Mimo początkowo stwierdzanych w obrazie histopatologicznym zmian mastopatycznych weryfikowano rozpoznanie, a kolejne biopsje nie wykazały obecności zmian nowotworowych. W obu przypadkach niegojące się owrzodzenia potraktowano jako infekcyjne powikłanie pooperacyjne. Rozpoznanie piodermii zgorzelinowej ustalono na podstawie charakterystycznego wywiadu, obrazu klinicznego oraz badania histologicznego. W leczeniu zastosowano cyklosporynę w połączeniu z dapsonem oraz cyklosporynę z glikokortykosteroidami i uzyskano bardzo szybką poprawę stanu miejscowego oraz ustąpienie bólu. Wnioski. Przedstawione przypadki ilustrują trudności diagnostyczne oraz rolę patergii w powstawaniu zmian w piodermii zgorzelinowej. Przebieg choroby i jej leczenie w obu przypadkach potwierdzają także nieskuteczność glikokortykosteroidów w monoterapii. AbStrActIntroduction. Pyoderma gangrenosum is a rare dermatosis with unknown etiology. Painful and quickly spreading ulcerations with necrotic bottom and heaped wound edges are typical. Objective. The aim of this study is to present patients with pyoderma gangrenosum which imitated breast cancer and their treatment. Case report. Two women suspected of having breast cancer developed painful and non-healing ulceration after surgical excision of nodules. Although in histopathology mastopathic changes were described, the diagnosis was verified and subsequent biopsies showed no cancerous changes. Ulcerations were treated as an infectious surgery complication. The diagnosis of pyoderma gangrenosum was made on the basis of characteristic anamnesis, clinical features and histopathological exaPiodermia zgorzelinowa, trudności diagnostyczne i terapeutyczne -opis dwóch przypadków imitujących raka piersi Pyoderma gangrenosum, diagnostic and therapeutic difficultiestwo cases imitating breast cancer

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Present status of pyoderma gangrenosum. Review of 21 cases

Cited by 67 publications

References 0 publications

Extraintestinal Manifestations of Crohn’s Disease

Extraintestinal Manifestations of Crohn’s Disease

Atypical pyoderma gangrenosum in inflammatory bowel disease: A severe diagnostic challenge

Pyoderma gangrenosum, diagnostic and therapeutic difficulties – two cases imitating breast cancer

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