Pyoderma gangrenosum as a initial manifestation of ulcerative proctocolitis

Abstract

301FONSECA CB, MOTTA GL, RAMPAZZO A, JUNIOR JCC, FAGUNDES RB. Pyoderma gangrenosum as a initial manifestation of ulcerative proctocolitis. Rev bras Coloproct, 2011;31(3): 301-305.AbstRACt: pyoderma gangrenosum is a rare inflammatory skin condition characterized by progressive and recurrent skin ulceration of destructive course. It is usually associated with rheumatoid arthritis, paraproteinemia, myeloproliferative diseases and inflammatory bowel diseases, especially non-specific ulcerative proctocolitis. In these situations, skin lesions are described as concurrent with the intestinal condition. However, reports on pyoderma gangrenosum preceding intestinal findings are less frequent. The authors describe a case of a woman with febrile condition associated with skin lesions diagnosed by biopsy as pyoderma gangrenosum. Two weeks later, she developed diarrhea, arthralgia and sepsis, being diagnosed as ulcerative proctocolitis. After the administration of the treatment for ulcerative proctocolitis, she showed improvements in sepsis care, remission of diarrhea and regression of skin lesions. This case highlights the importance of considering pyoderma gangrenosum as a manifestation associated with inflammatory bowel disease, regardless of its timing in relation to intestinal symptoms.

Pyoderma Gangrenosum of the Preauricular Area with Ulcerative Colitis: A Case Report and Review

“…Pathologic features of our case corresponded with infected preauricular fistula, as its epithelium was surrounded by connective tissue with inflammatory cells, but ulcerative destruction of the epidermis and superficial and deep dermatitis, with prevalence of neutrophils pointed towards PG rather than infected preauricular fistula. Pathoanatomical findings correlated with ulcerative PG as Fonseca, et al [ 10 ] reported, and it did much to diagnose the PG. Early biopsy of the lesion provided assistance to confirm the disease in our case, so we could treat UC as well as the skin lesion as a priority, and it was crucial for making a quick recovery as mentioned later.…”