Sick I, Trautner B, Ruzicka T
Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig- Maximilians-Universität München und Städtisches Klinikum München GmbH, Klinik Thalkirchner Strasse, Deutschland.
Hautarzt. 2012 Jul;63(7):577-83. doi: 10.1007/s00105-011-2269-8.
Pyoderma gangrenosum is a rare affection of unknown etiology, which is often associated with systemic diseases such as chronic inflammatory bowel disease, hematologic disorders, carcinomas and arthritis. Treatment may include topical corticosteroids or calcineurin inhibitors in combination with systemic corticosteroids, cyclosporine A, azathioprine, cyclophosphamide, mycophenolate mofetil, intravenous immunoglobulins or monoclonal antibodies against TNFα but all these approaches are off-label. Surgical therapy is difficult because of pathergy. Nevertheless, after having stopped the inflammation, the ulcers can be treated by split thickness skin grafts and simultaneous immunosuppression. We present three cases with successful surgical treatment.
坏疽性脓皮病是一种病因不明的罕见病症，常与慢性炎症性肠病、血液系统疾病、癌症和关节炎等全身性疾病相关。治疗方法可能包括外用皮质类固醇或钙调神经磷酸酶抑制剂，联合全身性皮质类固醇、环孢素A、硫唑嘌呤、环磷酰胺、霉酚酸酯、静脉注射免疫球蛋白或抗TNFα单克隆抗体，但所有这些方法均为超说明书用药。由于同形反应，手术治疗较为困难。然而，在炎症消退后，溃疡可通过分层皮片移植和同时进行免疫抑制来治疗。我们介绍三例手术治疗成功的病例。
