Tolkachjov Stanislav N, Sun Philip Y, Bridges Alina G
J Drugs Dermatol. 2017 Jul 1;16(7):711-713.
Pyoderma gangrenosum (PG) is a neutrophilic, ulcerative dermatosis that can develop at sites of cutaneous trauma, including surgical incisions, a phenomenon known as pathergy. The characteristic lesion is a painful, rapidly expanding ulceration with a violaceous undermined border. A biopsy taken from the expanding violaceous border shows predominantly neutrophilic dermal inflammation with neutrophilic abscess formation.
The etiology of PG appears to be variable among patients, as about a half of the reported cases are associated with systemic disease such as inflammatory bowel disease, rheumatoid arthritis, or myeloproliferative disorders, while the other half seem to be idiopathic. PG is difficult to diagnose as other etiologies, including infectious, vasculitic, and other inflammatory dermatoses, must be excluded. Histopathologic and biochemical markers of PG, such as dermal neutrophilic infiltrate or overexpression of interleukin-8, respectively, are not pathognomonic. Given that several drugs, such as hydralazine, mesalamine, and sunitinib, are reportedly associated with PG, failure to recognize this association and stop these medications may delay diagnosis and therapy. We report a case of idiopathic postoperative PG following video-assisted thoracic surgery (VATS).
J Drugs Dermatol. 2017;16(7):711-713.
.坏疽性脓皮病（PG）是一种嗜中性溃疡性皮肤病，可在包括手术切口在内的皮肤创伤部位发生，这一现象称为同形反应。其特征性损害是一个疼痛的、迅速扩大的溃疡，边缘呈紫红色且有潜行。取自扩大的紫红色边缘的活检显示主要为嗜中性真皮炎症并伴有嗜中性脓肿形成。
PG的病因在患者中似乎各不相同，约一半的报告病例与系统性疾病相关，如炎症性肠病、类风湿关节炎或骨髓增殖性疾病，而另一半似乎是特发性的。PG难以诊断，因为必须排除其他病因，包括感染性、血管炎性和其他炎症性皮肤病。PG的组织病理学和生化标志物，如真皮嗜中性浸润或白细胞介素-8的过表达，都不具有特异性。鉴于据报道几种药物，如肼屈嗪、美沙拉嗪和舒尼替尼，与PG有关，未能认识到这种关联并停用这些药物可能会延迟诊断和治疗。我们报告一例电视辅助胸腔镜手术（VATS）后特发性术后PG病例。
《皮肤药物学杂志》2017年；16（7）：711 - 713。
