Giroux J M, Ouellet A, Heppell J, Lacroix M
Service de Dermatologie, Hôpital Hôtel-Dieu de Montrèal, Québec, Canada.
Ann Dermatol Venereol. 1987;114(8):935-9.
Cutaneous manifestations of chronic ulcerative colitis are numerous and present in 20 p. 100 of the patients. The case of a 49-year old man with peristomal pyoderma gangrenosum (PG) is presented. In November, 1983, one year after the onset of chronic ulcerative colitis, the patient underwent total colectomy. The formation of an ileal reservoir resulted in a pelvic abscess which necessitated right lower ileostomy. Because of severe ulcerations around the stoma, the ileostomy was transferred to the left lower abdomen. Similar inflammatory ulcerations developed, and the diagnosis of pyoderma gangrenosum was made. The patient responded very well to dapsone combined with prednisone for only 6 months. The possibility of PG being an autoimmune condition is discussed, as well as the differential diagnosis. The several therapeutic approaches are summarized. The peristomal localization of PG in this patient suffering from chronic ulcerative colitis seems to be rather unique. No other case has been reported so far, to our knowledge.
慢性溃疡性结肠炎的皮肤表现多种多样，见于20%的患者。本文介绍了一名49岁患有造口周围坏疽性脓皮病（PG）的男性病例。1983年11月，在慢性溃疡性结肠炎发病一年后，该患者接受了全结肠切除术。回肠储袋的形成导致盆腔脓肿，需要行右下腹回肠造口术。由于造口周围严重溃疡，回肠造口术转移至左下腹。类似的炎性溃疡出现，遂诊断为坏疽性脓皮病。患者仅使用氨苯砜联合泼尼松治疗6个月，效果良好。文中讨论了PG作为自身免疫性疾病的可能性以及鉴别诊断。总结了几种治疗方法。PG在该慢性溃疡性结肠炎患者中的造口周围定位似乎相当独特。据我们所知，目前尚未有其他病例报道。
