Pyoderma gangrenosum in a kindred

Shands, Joseph W.; Flowers, F.P.; Hill, Hugh M.; Smith, J. Orson

doi:10.1016/s0190-9622(87)70116-9

Cited by 49 publications

(8 citation statements)

References 7 publications

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“…Of the remaining children, two were HIV positive (19), one had IgA deficiency (20), and one had a neutrophil and T cell deficiency (21). Twelve (26.6%) had no underlying disorder (22)(23)(24)(25)(26)(27)(28)(29)(30)(31), which is comparable to the 20% to 30% figure reported for adults (33).…”

Section: Associated Disordersmentioning

confidence: 62%

“…was recognized as the factor responsible for development of the ulcers (8,9,12,17,19,20,22,27,29,30). Infants of less than 1 year followed a similar trend, with pustules the most common presenting lesion.…”

Section: Clinical Findingsmentioning

confidence: 94%

“…Refractory lesions have been treated successfully with the addition of dapsone (19,31), clofazimine (20), rifampin (13,31), and cyclophosphamide (29) to the steroid regimen. In some cases, the ulcers healed with antibiotics (31), topical agents (1,27,19), or hyperbaric oxygen (23). Adults with recalcitrant disease may respond well to clofazimine (39) or cyclosporine (40); none of the 46 children received cyclosporine.…”

Section: Treatmentmentioning

confidence: 99%

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Pyoderma Gangrenosum in Infants and Children

Graham¹,

Hansen²,

Rabinowitz

et al. 1994

Pediatric Dermatology

128

108

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Pyoderma gangrenosum is an uncommon ulcerative skin disorder that occurs in all age groups. Approximately 4% of patients are infants and children. There are several notable differences between the childhood and adult manifestations of the disease, including the distribution of lesions and associated disorders. We reviewed the childhood cases (< or = 18 yrs of age) of unequivocal pyoderma gangrenosum in the English literature and tabulated the trends in clinical features, associated disorders, and therapy. We report our 3-week-old patient, the youngest documented case. Of the 46 patients, only 4 were less than 1 year of age. A systemic illness was present in 74% of the older children, most commonly, ulcerative colitis. Only one infant had an associated problem (HIV+) at the time of onset. Infants appear to have an unusual distribution of perianal and genital lesions not often described in other age groups. Our review suggests that pyoderma gangrenosum in children has a similar clinical appearance to that in adults. It is associated with some of the same underlying disorders, but with different frequencies. The distribution of lesions in children is similar, often involving the lower extremities, but pyoderma gangrenosum of the head and face appears to be more common in children. Infants may have ulcers in genital and perianal areas. The most frequently prescribed treatment for children is systemic corticosteroids, which generally are very effective.

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Section: Associated Disordersmentioning

confidence: 62%

Section: Clinical Findingsmentioning

confidence: 94%

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Pyoderma Gangrenosum in Infants and Children

Graham¹,

Hansen²,

Rabinowitz

et al. 1994

Pediatric Dermatology

128

108

View full text Add to dashboard Cite

show abstract

“…Three case reports in the pediatric population describe familial PG in both the setting and absence of systemic disease 10– 12 . Other case reports describe the development of PG in family members after abdominal surgery and trauma 13 . In addition, there are familial cases of PG-associated genetic syndromes in the literature 14 .…”

Section: Pathophysiologymentioning

confidence: 99%

Recent advances in managing and understanding pyoderma gangrenosum

2019

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Pyoderma Gangrenosum (PG) is a rare neutrophilic dermatosis with multiple different clinical presentations and associated comorbidities. PG has historically been a challenging disorder to diagnose, leading to the development of new diagnostic criteria rather than the traditional approach of a diagnosis of exclusion. The pathophysiology is thought to involve both innate and adaptive immune system dysregulation, neutrophilic abnormalities, environmental, and genetic factors. As of today, no gold standard therapy exists for the treatment of PG, and the literature is restricted to mainly case reports, case series, and 2 small randomized clinical trials. Topical, systemic, and biologic therapy, as well as adequate analgesia and proper wound care all play a role in the management of PG. Recent studies have identified additional cytokines and signalling cascades thought to be involved in the pathogenesis of PG, ultimately leading to the development of new targeted therapies. This review will focus on recent advances in the pathophysiology, clinical presentation and associated comorbidities, diagnosis, and management of PG.

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“…This association has been reported in 16 individual cases: seven cases during pregnancy; eight after cesarean delivery; and one case during the postnatal period. Of the eight cases of PG after cesarean delivery, only four patients had no associated disease . In all of these cases, PG developed in the surgical wound 1–6 days after cesarean delivery.…”

Section: Discussionmentioning

confidence: 93%

Recurrent pyoderma gangrenosum after cesarean delivery successfully treated with vacuum‐assisted closure and split thickness skin graft: A case report

Aydın

Uğurlucan

et al. 2014

J of Obstet and Gynaecol

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We describe the case of a 32-year-old woman (gravidity: 4; parity: 2) who underwent cesarean delivery at 37 weeks of gestation and presented with dehiscence and infection of the surgical wound. She had a history of wound infection and dehiscence of the scar from a previous cesarean delivery and dehiscence in the dorsal side of her left hand at the site of intravenous catheterization. The patient was initially diagnosed with a skin infection and later with pyoderma gangrenosum. No evidence of any underlying disease was found. The lesions were treated with systemic corticosteroids and azathioprine, but the lesions were unresponsive to treatment. This complicated case of pyoderma gangrenosum after cesarean delivery, which initially mimicked wound infection, was successfully treated with vacuum-assisted closure and split-thickness skin graft. This synergistic approach with vacuum-assisted closure could be an important treatment option for aggressive and slow-healing lesions.

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Pyoderma gangrenosum in a kindred

Cited by 49 publications

References 7 publications

Pyoderma Gangrenosum in Infants and Children

Pyoderma Gangrenosum in Infants and Children

Recent advances in managing and understanding pyoderma gangrenosum

Recurrent pyoderma gangrenosum after cesarean delivery successfully treated with vacuum‐assisted closure and split thickness skin graft: A case report

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