Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
J Dermatol. 2010 Aug;37(8):714-7. doi: 10.1111/j.1346-8138.2010.00961.x.
A 51-year-old Japanese woman underwent subtotal colectomy for ulcerative colitis 5 years before her first visit to our hospital, and her symptoms stabilized. She presented with a 2-month history of proliferative, pustular lesions on her face, scalp, and gingival and anal mucosae. Histological examination showed features similar to those of pemphigus vegetans. However, the results of immunofluorescence studies, immunoblot analysis and enzyme-linked immunosorbent assay for pemphigus were negative, and colonoscopy revealed a relapse of ulcerative colitis in the remaining rectal mucosa, so a diagnosis of pyodermatitis-pyostomatitis vegetans was made. This is the first report of mucocutaneous lesions that developed with a relapse of ulcerative colitis in the remaining rectum after subtotal colectomy. Moreover, a close correlation was found between the condition of bowel inflammation and that of mucocutaneous lesions.
一位 51 岁的日本女性在因溃疡性结肠炎接受部分结肠切除术 5 年后首次来我院就诊，她的症状得到稳定控制。此次就诊前 2 个月，她出现了面部、头皮、牙龈和肛门黏膜的增殖性脓疱病变。组织学检查显示类似于增殖性天疱疮的特征。然而，免疫荧光研究、免疫印迹分析和天疱疮酶联免疫吸附试验的结果均为阴性，结肠镜检查显示剩余直肠黏膜的溃疡性结肠炎复发，因此诊断为坏疽性脓皮病-溃疡性天疱疮。这是首例报道的在接受部分结肠切除术切除后剩余直肠的溃疡性结肠炎复发后出现的黏膜皮肤病变。此外，还发现肠道炎症与黏膜皮肤病变之间存在密切相关性。
