Chae Hee Sung, Han Sung Min, Lee Ha Neul, Jeon Hyun Jong, Seo Young Joon
Department of Otorhinolaryngology-Head and Neck Surgery, Wonju Severance Christian Hospital, Yonsei University College of Medicine, Wonju, Korea.
J Audiol Otol. 2018 Oct;22(4):248-252. doi: 10.7874/jao.2018.00171. Epub 2018 Jun 14.
Pyoderma gangrenosum (PG) is primarily, a sterile, inflammatory, neutrophilic dermatosis, characterized by recurrent cutaneous ulceration with mucopurulent or hemorrhagic exudate. The incidence of PG is uncertain, but it is estimated to be about 3-10 patients per million per year. It occurs most commonly on the lower legs, but has been reported at other sites of the body as well. The causes of PG are unknown, but about 50-70% of cases are associated with other diseases, mainly inflammatory bowel disease. We hereby report a case of PG in a 21-year-old male, with a history of ulcerative colitis (UC). After appropriate diagnostic methods including biopsy for pathologic confirmation, sigmoidoscopy and computed tomography, we excluded other diseases and the lesion was diagnosed as PG. We then carried out regular dressing of the wound, while UC was treated with steroid and immunosuppressant medication, with inputs from the department of gastroenterology during the hospital stay. There occurred recurrence of the skin lesion, 7 months after discharge, after which they improved. UC has been in the remission state as per the follow-up, since 2 years.
坏疽性脓皮病(PG)主要是一种无菌性、炎症性、嗜中性皮病,其特征为皮肤反复溃疡并伴有黏液脓性或血性渗出物。PG的发病率尚不确定,但估计约为每年每百万人中有3至10例患者。它最常发生于小腿,但也有在身体其他部位出现的报道。PG的病因不明,但约50%至70%的病例与其他疾病相关,主要是炎症性肠病。我们在此报告一例21岁男性的PG病例,该患者有溃疡性结肠炎(UC)病史。经过包括活检进行病理确诊、乙状结肠镜检查和计算机断层扫描等适当的诊断方法后,我们排除了其他疾病,该病变被诊断为PG。然后我们对伤口进行了定期换药,同时UC采用类固醇和免疫抑制药物治疗,住院期间有胃肠病科参与。出院7个月后皮肤病变复发,之后有所改善。根据随访情况,UC自两年以来一直处于缓解状态。