Petering H, Kiehl P, Breuer C, Kapp A, Werfel T
Dermatologische Klinik und Poliklinik, Medizinische Hochschule Hannover.
Hautarzt. 2001 Jan;52(1):47-50. doi: 10.1007/s001050051261.
Pyoderma gangrenosum is a distinct clinical entity characterized by chronic, recurring, destructive ulcerations. Although the pathogenesis of pyoderma gangrenosum is unknown, immunologic aberrations of neutrophil granulocytes seem to be important. Systemic steroids and macrolide lactones such as cyclosporin A and tacrolimus have been reported to be useful in the clinical management of disease. Pyoderma gangrenosum has been found to be associated with several systemic diseases. The association with chronic ulcerative colitis is well known, but the diagnosis may be complicated by early administration of systemic steroids. Therefore, local immunosuppression with topically applied agents could be an efficient therapeutic alternative especially for mild or early cutaneous lesions.We describe the successful topical treatment of a patient with multiple lesions of pyoderma gangrenosum with 0,1% tacrolimus (FK506) ointment which is known to have better dermal penetration and higher immunosuppressive potency than topical cyclosporin A. In addition, other indications for topical tacrolimus are discussed.
坏疽性脓皮病是一种独特的临床实体，其特征为慢性、复发性、破坏性溃疡。尽管坏疽性脓皮病的发病机制尚不清楚，但中性粒细胞的免疫异常似乎很重要。据报道，全身用类固醇和大环内酯类药物如环孢素A和他克莫司在该病的临床治疗中有用。已发现坏疽性脓皮病与多种全身性疾病有关。与慢性溃疡性结肠炎的关联众所周知，但早期使用全身用类固醇可能会使诊断复杂化。因此，局部应用药物进行局部免疫抑制可能是一种有效的治疗选择，特别是对于轻度或早期皮肤病变。我们描述了用0.1%他克莫司（FK506）软膏成功局部治疗一名患有多处坏疽性脓皮病病变的患者，已知该软膏比局部用环孢素A具有更好的皮肤渗透性和更高的免疫抑制效力。此外，还讨论了局部用他克莫司的其他适应证。
