Shelley E D, Shelley W B
Department of Medicine, Medical College of Ohio, Toledo 43699.
J Am Acad Dermatol. 1988 May;18(5 Pt 1):1084-8. doi: 10.1016/s0190-9622(88)70111-5.
Malignant pyoderma of the right ear developed in a 58-year-old woman, and it spread insidiously over the entire right side of the face. Pyoderma gangrenosum was diagnosed on the basis of clinical and histologic findings and the patient's history of ulcerative colitis and sclerosing cholangitis. After successive therapeutic failures with a score of conventional approaches over an 18-month period, oral cyclosporine, 10 mg/kg/day, was started. Significant healing of the skin was noted within 1 month. There was an associated remission of the patient's cholangitis and inflammatory bowel disease. The dosage of cyclosporine was progressively tapered and then discontinued after 7 months, when healing was complete. No relapse occurred in the subsequent 14 months, and there was an associated remission of the patient's cholangitis and inflammatory bowel disease. Cyclosporine merits serious attention for treatment of both pyoderma gangrenosum and sclerosing cholangitis.
一名58岁女性右耳出现恶性脓皮病，并逐渐蔓延至右侧整个面部。根据临床和组织学检查结果以及患者的溃疡性结肠炎和硬化性胆管炎病史，诊断为坏疽性脓皮病。在18个月内采用一系列传统方法治疗均失败后，开始口服环孢素，剂量为10mg/kg/天。1个月内皮肤明显愈合。患者的胆管炎和炎症性肠病也随之缓解。环孢素剂量逐渐减少，7个月后伤口完全愈合停药。在随后的14个月中未复发，患者的胆管炎和炎症性肠病也持续缓解。环孢素在治疗坏疽性脓皮病和硬化性胆管炎方面值得高度关注。
