Moreira Catarina, Lopes Sofia, Cruz Maria João, Azevedo Filomena
Centro Hospitalar São João, Porto, Portugal.
Faculty of Medicine, University of Porto, Porto, Portugal.
BMJ Case Rep. 2017 Jan 27;2017:bcr2016218589. doi: 10.1136/bcr-2016-218589.
Treatment of pyoderma gangrenosum (PG) remains a challenge, and there are currently no specific or uniformly effective therapies. Although widespread or rapidly progressive disease often requires systemic treatment, localised and mild lesions may be effectively controlled with topical agents. The most frequently applied topical drugs are corticosteroids and calcineurin inhibitors. Recently, a patient with idiopathic PG of the lower limb was successfully treated with topical timolol and collagenase. Here, we report a case of a patient with collagenous colitis, ankylosing spondylitis and periumbilical PG. Persistent ulcerated skin lesions were successfully treated with topical timolol, although a flare of the underlying bowel disease temporarily interrupted the improvement. The case presented enhances the previously reported therapeutic potential of topical timolol in the treatment of PG. Control of chronic underlying disorders is critical to prevent rebound flares and maintain the benefit.
坏疽性脓皮病（PG）的治疗仍然是一项挑战，目前尚无特效或统一有效的治疗方法。尽管广泛或快速进展的疾病通常需要全身治疗，但局部和轻度病变可用局部用药有效控制。最常应用的局部用药是皮质类固醇和钙调神经磷酸酶抑制剂。最近，一名下肢特发性PG患者成功接受了局部噻吗洛尔和胶原酶治疗。在此，我们报告一例患有胶原性结肠炎、强直性脊柱炎和脐周PG的患者。尽管潜在肠道疾病的发作暂时中断了病情改善，但持续性溃疡性皮肤病变通过局部噻吗洛尔成功治愈。该病例进一步证明了先前报道的局部噻吗洛尔治疗PG的潜在疗效。控制慢性基础疾病对于预防病情反弹和维持疗效至关重要。
