Gastroenterología, Hospital Interzonal General de Agudos (HIGA) "General San Martín", Argentina.
Dermatología, Hospital Interzonal General de Agudos (HIGA) "General San Martín", Argentina.
Rev Esp Enferm Dig. 2021 Oct;113(10):691-697. doi: 10.17235/reed.2020.7431/2020.
dermatological manifestations are normally found in one third of patients with inflammatory bowel disease. In this study, the prevalence, clinical characteristics, intestinal disease activity, and treatment response of neutrophilic dermatoses (pyoderma gangrenosum and Sweet´s syndrome) were determined in patients with inflammatory bowel disease.
a retrospective, observational study was performed in patients with inflammatory bowel disease and neutrophilic dermatoses between March 2012 and March 2018.
of 444 patients analyzed, 10 complied with the inclusion criteria. Seven had pyoderma gangrenosum and three presented Sweet's syndrome; and one patient developed both pathologies. The prevalence of neutrophilic dermatoses was 2.3 % (10/444), comprising 1.6 % with pyoderma gangrenosum and 0.7 % with Sweet's syndrome. Six out of seven patients with pyoderma gangrenosum were female and had ulcerative colitis. The most frequent clinical presentation of pyoderma gangrenosum was the ulcerative subtype. Active moderate-to-severe intestinal disease was found in 71.4 % of patients. Biological therapy was prescribed to three patients with partial response to corticosteroids and persistent intestinal disease activity. This therapy was not indicated for cutaneous manifestations only. Three patients with moderate-to-severe Crohn´s disease presented classical (n = 2) and pustular (n = 1) Sweet's syndrome. A complete response was achieved in all Sweet's syndrome cases treated with corticosteroids. Biological therapy was prescribed to control intestinal disease activity.
pyoderma gangrenosum was the most frequent cutaneous manifestation of neutrophilic dermatoses, predominantly in females with ulcerative colitis, and highly associated with intestinal disease activity. Anti-tumor necrosis factor was effective in patients with partial cutaneous and intestinal disease response.
皮肤病表现通常见于三分之一的炎症性肠病患者。本研究旨在确定炎症性肠病患者中性粒细胞皮肤病（坏疽性脓皮病和Sweet 综合征）的患病率、临床特征、肠道疾病活动度和治疗反应。
对 2012 年 3 月至 2018 年 3 月期间患有炎症性肠病和中性粒细胞皮肤病的患者进行回顾性、观察性研究。
在分析的 444 例患者中，有 10 例符合纳入标准。7 例患有坏疽性脓皮病，3 例患有 Sweet 综合征；1 例患者同时发生这两种疾病。中性粒细胞皮肤病的患病率为 2.3%（10/444），其中坏疽性脓皮病占 1.6%，Sweet 综合征占 0.7%。7 例坏疽性脓皮病患者中有 6 例为女性，均患有溃疡性结肠炎。坏疽性脓皮病最常见的临床表现为溃疡性亚型。71.4%的患者存在活动期中重度肠道疾病。由于对皮质类固醇治疗有部分反应且持续存在肠道疾病活动，故对 3 例患者采用生物治疗。该治疗不仅针对皮肤表现。3 例中重度克罗恩病患者出现经典（n=2）和脓疱型（n=1）Sweet 综合征。所有接受皮质类固醇治疗的 Sweet 综合征患者均获得完全缓解。为控制肠道疾病活动度而开具了生物治疗处方。
坏疽性脓皮病是中性粒细胞皮肤病最常见的皮肤表现，主要见于溃疡性结肠炎女性患者，且与肠道疾病活动度高度相关。抗肿瘤坏死因子对皮肤和肠道疾病有部分反应的患者有效。
