Chia M W, Teo L, Tay Y K, Poh W T
Division of Dermatology, Changi General Hospital, Singapore, Division of Pathology, Changi General Hospital, Singapore.
Dermatol Online J. 2008 Feb 28;14(2):21.
Pustular pyoderma gangrenosum is a relatively uncommon clinical form of pyoderma gangrenosum; it presents with vesiculo-pustular lesions that do not develop into frank ulceration. We report a case of a 44-year-old man with associated ulcerative colitis, who was misdiagnosed as having necrotizing fasciitis. He underwent multiple debridements and a subsequent skin grafting procedure, but without improvement. The diagnosis of pyoderma gangrenosum is often challenging because there is no defining diagnostic clinical, laboratory, or histopathological feature. A high index of suspicion is, therefore, essential to diagnose pyoderma gangrenosum clinically because failure to do so in the early stages of the disease can lead to disfigurement and even unnecessary and detrimental surgery.
脓疱型坏疽性脓皮病是坏疽性脓皮病一种相对不常见的临床类型；它表现为水疱脓疱性损害，不会发展为明显的溃疡。我们报告一例44岁伴有溃疡性结肠炎的男性患者，他被误诊为坏死性筋膜炎。他接受了多次清创术及随后的皮肤移植手术，但病情并无改善。坏疽性脓皮病的诊断通常具有挑战性，因为没有明确的诊断性临床、实验室或组织病理学特征。因此，临床诊断坏疽性脓皮病时高度的怀疑指数至关重要，因为在疾病早期未能如此可能导致毁容，甚至进行不必要且有害的手术。
