Kim Yoon Soo, Kim Han Kyeol, Han Yea Sik
Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea.
Arch Craniofac Surg. 2014 Dec;15(3):138-141. doi: 10.7181/acfs.2014.15.3.138. Epub 2014 Dec 23.
Pyoderma gangrenosum is a rare inflammatory reactive dermatosis marked by painful cutaneous ulcers. Diagnosis of pyoderma gangrenosum is usually made based on past medical history and after the exclusion of other possible diseases based on the clinical manifestations of the lesion. Diseases that show rapid progression to necrosis and that should not be misdiagnosed as pyoderma gangrenosum include malignant neoplasms and necrotizing fasciitis. Immunosuppressive agents such as steroids and cyclosporine are considered first-line therapy. Surgical removal of the necrotic tissues is contraindicated, as it may further induce immune reaction and promote ulcer to enlarge. Here, we present a case to encourage plastic surgeons to consider pyodermagangrenosum in the differential diagnosis of idiopathic ulcers. Satisfactory outcomes for patients with pyodermagangrenosum may be expected when using steroids and immunosuppressive agents during the early stage of the disease.
坏疽性脓皮病是一种罕见的炎症性反应性皮肤病，其特征为疼痛性皮肤溃疡。坏疽性脓皮病的诊断通常基于既往病史，并根据病变的临床表现排除其他可能的疾病后做出。表现为迅速进展至坏死且不应误诊为坏疽性脓皮病的疾病包括恶性肿瘤和坏死性筋膜炎。类固醇和环孢素等免疫抑制剂被视为一线治疗药物。禁忌手术切除坏死组织，因为这可能会进一步诱发免疫反应并促使溃疡扩大。在此，我们报告一例病例，以促使整形外科医生在特发性溃疡的鉴别诊断中考虑坏疽性脓皮病。在疾病早期使用类固醇和免疫抑制剂时，坏疽性脓皮病患者有望获得满意的疗效。
