Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Mod Rheumatol Case Rep. 2023 Dec 29;8(1):11-15. doi: 10.1093/mrcr/rxad051.
Pyoderma gangrenosum (PG) is a rare inflammatory skin disease characterised by skin ulcers that are associated with autoimmune diseases. Although the effectiveness of immunosuppression with glucocorticoids and tumour necrosis factor inhibitors in treating PG has been reported, the utility of negative-pressure wound therapy (NPWT) for severe ulcerative lesions in patients with PG remains controversial. Herein, we report the case of a 76-year-old woman with rheumatoid arthritis who developed PG after undergoing surgery for a forefoot deformity. The patient showed improvement in deep ulcer lesions through NPWT while receiving treatment with abatacept and systemic glucocorticoids. Subsequent topical glucocorticoid therapy led to the remission of the PG. This case suggests that NPWT, when used under immunosuppressive conditions, does not exacerbate the pathergy and may be beneficial for treating severe ulcerative PG.
坏疽性脓皮病（PG）是一种罕见的炎症性皮肤病，其特征为皮肤溃疡，与自身免疫性疾病有关。尽管已有报道称糖皮质激素和肿瘤坏死因子抑制剂的免疫抑制作用对 PG 的治疗有效，但负压伤口疗法（NPWT）对 PG 患者严重溃疡性病变的疗效仍存在争议。在此，我们报告了一例 76 岁女性类风湿关节炎患者，该患者在前足畸形手术后发生 PG。在接受阿巴西普和全身糖皮质激素治疗的同时，NPWT 使患者的深部溃疡病变得到改善。随后局部糖皮质激素治疗使 PG 缓解。该病例提示，在免疫抑制条件下使用 NPWT 不会加重化脓性汗腺炎，且可能对治疗严重溃疡性 PG 有益。
