Department of Dermatology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
J Dermatol. 2010 Jan;37(1):107-10. doi: 10.1111/j.1346-8138.2009.00756.x.
We present a case of pyoderma gangrenosum localized on the breast, without a preceding surgical intervention and associated systemic disorder. The ulcer had rapidly developed and covered a large portion of the breast. The patient responded well to systemic steroids and salicylazosulfapyridine and the ulcer completely healed with scarring after 3 months of treatment. Pyoderma gangrenosum rarely involves the breasts. A published work survey disclosed only 31 reported cases up to date. In most of these cases the lesions were related to previous surgical interventions, probably as the result of a pathergy phenomenon. The main differential diagnoses were skin and soft tissue infections including necrotizing fasciitis, and malignant neoplasms. Negative initial wound cultures and the relative sparing of nipple/areola complex helped to eliminate these disorders. Though an unusual site for pyoderma gangrenosum, lesions on the breast showed the characteristic clinical features of the disease. The types of associated disorders were also similar to those of the cases with classical pyoderma gangrenosum. As most of the lesions healed with significant scarring, early recognition and treatment of pyoderma gangrenosum located on the breast is important to prevent serious physical and psychological morbidity.
我们报告了一例局限于乳房的坏疽性脓皮病，无先前手术干预和相关全身疾病。溃疡迅速发展，覆盖了乳房的大部分区域。患者对全身皮质类固醇和柳氮磺胺吡啶反应良好，经过 3 个月的治疗，溃疡完全愈合并留下瘢痕。坏疽性脓皮病很少累及乳房。目前已发表的文献调查仅发现了 31 例报道病例。在这些病例中，病变大多与先前的手术干预有关，可能是由于异物反应现象。主要的鉴别诊断包括皮肤和软组织感染，包括坏死性筋膜炎，以及恶性肿瘤。初始伤口培养阴性，乳头/乳晕复合体相对不受影响，有助于排除这些疾病。尽管乳房是坏疽性脓皮病的不常见部位，但病变表现出了该疾病的特征性临床特征。相关疾病的类型也与经典坏疽性脓皮病的病例相似。由于大多数病变愈合后留下明显的瘢痕，因此早期识别和治疗位于乳房的坏疽性脓皮病对于预防严重的身体和心理疾病非常重要。
