Sagami Shintaro, Ueno Yoshitaka, Tanaka Shinji, Nagai Kenta, Hayashi Ryohei, Chayama Kazuaki
Department of Medicine and Molecular Science, Hiroshima University, Japan.
Intern Med. 2015;54(17):2167-72. doi: 10.2169/internalmedicine.54.4853. Epub 2015 Sep 1.
A 52-year-old woman with ulcerative colitis was admitted to our hospital for an ulcerative colitis flare-up under salazosulfapyridine therapy. The symptoms improved with high-dose corticosteroids. After prednisolone was tapered to 10 mg, the frequency of diarrhea increased. The diarrhea was accompanied by joint pain and a skin ulcer with abscess formation, which was diagnosed to be pyoderma gangrenosum. The patient was started on adalimumab. A positive response to the adalimumab therapy was observed after 2 weeks, during which time the ulcerative skin lesion healed completely, however, colonic mucosal healing was achieved at 2 months. Therefore, adalimumab appears to be an effective therapeutic option for patients with ulcerative colitis-associated pyoderma gangrenosum.
一名52岁的溃疡性结肠炎女性患者因在柳氮磺胺吡啶治疗期间溃疡性结肠炎发作而入住我院。高剂量皮质类固醇治疗后症状改善。泼尼松龙减至10mg后，腹泻频率增加。腹泻伴有关节疼痛和形成脓肿的皮肤溃疡，诊断为坏疽性脓皮病。该患者开始使用阿达木单抗治疗。2周后观察到对阿达木单抗治疗有阳性反应，在此期间溃疡性皮肤病变完全愈合，然而，结肠黏膜愈合在2个月时实现。因此，阿达木单抗似乎是溃疡性结肠炎相关坏疽性脓皮病患者的一种有效治疗选择。
