Mirkamali A, Martha B, Dutronc Y, Ponnelle T, Pana L, Favrolt N, Chavanet P, Bernard A, Piroth L
Service des maladies infectieuses et tropicales, CHU de Dijon, 10, boulevard Maréchal-de-Lattre-de-Tassigny, 21079 Dijon cedex, France.
Med Mal Infect. 2007 Dec;37(12):835-9. doi: 10.1016/j.medmal.2007.05.002. Epub 2007 Jul 12.
Pyoderma gangrenosum is the ulcerative form of neutrophilic dermatoses. The most frequent extracutaneous localizations are the lungs, joints, and digestive tract.
We report a case of Pyoderma gangrenosum, which presented first as an aseptic lung abscess. The first cutaneous lesions occurred 9 months later, with skin ulcerations on the thorax and on surgical scars. The histological diagnosis was made on skin biopsies. There was no associated abnormality except for IgA monoclonal gammapathy. Clinical improvement was noted with immunosuppressive treatment.
This infrequent case report underlines that lung abscesses may be of non-infectious origin, that in Pyoderma gangrenosum, skin lesions may be come several months after extracutaneous manifestations, among which lungs abcesses are the most frequent.
坏疽性脓皮病是嗜中性皮病的溃疡性形式。最常见的皮肤外定位是肺部、关节和消化道。
我们报告一例坏疽性脓皮病，最初表现为无菌性肺脓肿。9个月后出现首批皮肤病变，胸部和手术瘢痕处出现皮肤溃疡。通过皮肤活检做出组织学诊断。除IgA单克隆丙种球蛋白病外无相关异常。免疫抑制治疗后临床症状改善。
这例罕见的病例报告强调，肺脓肿可能是非感染性起源，在坏疽性脓皮病中，皮肤病变可能在皮肤外表现出现数月后出现，其中肺脓肿最为常见。
