Yang Xiaoli, Wu Yongzhuo, Jiang Fuqiong, Deng Danqi
Department of Dermatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, People's Republic of China.
Clin Cosmet Investig Dermatol. 2024 Feb 28;17:493-498. doi: 10.2147/CCID.S449404. eCollection 2024.
Pyoderma gangrenosum (PG) is a rare cause of skin ulcers in children, posing challenges in diagnosis and treatment. As the disease is often associated with conditions such as inflammatory bowel disease (IBD), rheumatoid arthritis, haematological disorders and other diseases, diagnosis and treatment often require cooperation with other medical departments. Accordingly, dissemination of information about the disease to doctors in departments other than dermatologists, especially paediatricians, can help in its early detection.
The 11-year-old pediatric patient in the case initially diagnosed with acute febrile neutrophilic dermatosis was eventually confirmed as pustular PG through histopathological examinations of skin and other relevant examinations. The medical condition is lessened after treatment with a combination of glucocorticoids and adalimumab.
PG is relatively rare in clinical settings, particularly among pediatric patients exhibiting persistent high fever and signs of pustular pyoderma gangrenosum. This case underscores the importance of considering the potential diagnosis of pediatric pustular PG when confronted with a child presenting persistent high fever and pustules after trauma. Additionally, the proactive initiation of adalimumab emerges as a promising treatment option for pediatric IBD -associated pustular PG.
坏疽性脓皮病（PG）是儿童皮肤溃疡的罕见病因，在诊断和治疗方面存在挑战。由于该疾病常与炎症性肠病（IBD）、类风湿性关节炎、血液系统疾病等病症相关，诊断和治疗通常需要与其他医学科室合作。因此，向皮肤科以外科室的医生，尤其是儿科医生传播有关该疾病的信息，有助于早期发现。
该病例中的11岁儿科患者最初被诊断为急性发热性嗜中性皮病，最终通过皮肤组织病理学检查及其他相关检查确诊为脓疱型PG。经糖皮质激素和阿达木单抗联合治疗后病情缓解。
PG在临床环境中相对罕见，尤其是在出现持续高热和脓疱型坏疽性脓皮病体征的儿科患者中。该病例强调了面对外伤后出现持续高热和脓疱的儿童时，考虑小儿脓疱型PG潜在诊断的重要性。此外，对于小儿IBD相关脓疱型PG，积极启用阿达木单抗是一种有前景的治疗选择。
