Duchnowska Renata, Ziajka Ewa, Góralska Agnieszka, Grala Bartłomiej
Department of Oncology, Military Institute of Medicine, Szaserów 128 Street, 04-141 Warsaw, Poland.
J Med Case Rep. 2014 Jun 25;8:226. doi: 10.1186/1752-1947-8-226.
Pyoderma gangrenosum is a rare clinical entity of poorly understood pathogenesis, characterized by rapidly progressing skin necrosis. In around half of patients pyoderma gangrenosum is a manifestation of underlying systemic diseases, such as rheumatoid arthritis, inflammatory bowel disease or myeloproliferative disorders. There have been very few reports on the association of pyoderma gangrenosum with solid malignancies.
We report a case of a 68-year-old Caucasian woman in whom pyoderma gangrenosum first appeared around 30 years earlier, at the time of exacerbation of rheumatoid arthritis, and recurred as a manifestation of locally advanced breast cancer. The causative role of the neoplastic process was partly confirmed by the healing of the skin ulceration only following effective endocrine cancer therapy, whereas earlier attempts with standard anti-inflammatory therapy were unsuccessful.
Pyoderma gangrenosum has a recurrent nature and may be reactivated by various causes within several years. Therefore, a prompt and thorough diagnosis accompanied by treatment of the underlying disease is necessary.
坏疽性脓皮病是一种发病机制尚不清楚的罕见临床病症，其特征为皮肤坏死迅速进展。约半数患者的坏疽性脓皮病是潜在系统性疾病的表现，如类风湿关节炎、炎症性肠病或骨髓增殖性疾病。关于坏疽性脓皮病与实体恶性肿瘤关联的报道极少。
我们报告一例68岁白种女性病例，其坏疽性脓皮病首次出现于约30年前类风湿关节炎病情加重时，后作为局部晚期乳腺癌的一种表现复发。仅在内分泌癌有效治疗后皮肤溃疡才愈合，这部分证实了肿瘤过程的致病作用，而早期采用标准抗炎治疗未成功。
坏疽性脓皮病具有复发性，可能在数年内因各种原因重新激活。因此，迅速而全面的诊断并伴有对基础疾病的治疗是必要的。
