伴有无菌性脾脓肿的坏疽性脓皮病

[Pyoderma gangrenosum with aseptic spleen abscess].

作者信息

Brahimi N, Maubec E, Boccara O, Marinho E, Valeyrie-Allanore L, Lecaille C, Sebban V, Hersent B, Picard-Dahan C, Descamps V, Crickx B

机构信息

Service de dermatologie, hôpital Bichat, Assistance publique-Hôpitaux de Paris, université Paris-VII Denis-Diderot, 46, rue Henri-Huchard, 75877 Paris cedex 18, France.

出版信息

Ann Dermatol Venereol. 2009 Jan;136(1):46-9. doi: 10.1016/j.annder.2008.10.019. Epub 2008 Dec 9.

DOI:10.1016/j.annder.2008.10.019

PMID:19171230

Abstract

BACKGROUND

Pyoderma gangrenosum is a neutrophilic dermatosis in which systemic involvement is rare. It may be associated with systemic disease. We report a case of pyoderma gangrenosum in the spleen.

CASE REPORT

A 68-year-old man presenting pyoderma gangrenosum with pustules and stage I multiple myeloma was admitted for asthenia and abdominal pain. There were no skin lesions. Laboratory tests showed inflammatory syndrome with polynuclear leucocytes of 25,000/mm(3). CAT scans and abdominal ultrasound revealed a splenic abscess. A spleen biopsy was performed and histological examination showed polynuclear leukocyte infiltration, while cultures were negatives. Diagnosis of pyoderma gangrenosum with splenic involvement was made. Increased systemic corticosteroid therapy produced a successful outcome. Haematological findings remained unchanged.

DISCUSSION

Spleen involvement in pyoderma gangrenosum is very rare and can mimic an infectious process. In such cases, routine screening is essential for associated diseases, particularly haematological malignancies.

摘要

背景

坏疽性脓皮病是一种中性粒细胞性皮肤病，很少累及全身。它可能与全身性疾病有关。我们报告一例发生于脾脏的坏疽性脓皮病病例。

病例报告

一名68岁男性，患有伴有脓疱的坏疽性脓皮病及I期多发性骨髓瘤，因乏力和腹痛入院。当时无皮肤病变。实验室检查显示炎症综合征，多核白细胞计数为25,000/mm³。计算机断层扫描（CAT）和腹部超声检查发现脾脏脓肿。进行了脾脏活检，组织学检查显示多核白细胞浸润，而培养结果为阴性。诊断为累及脾脏的坏疽性脓皮病。增加全身皮质类固醇治疗取得了成功。血液学检查结果未变。