Schwaitzberg S D, Bradshaw M W, Williams T W
Arch Surg. 1982 Mar;117(3):363-7. doi: 10.1001/archsurg.1982.01380270075017.
Pyoderma gangrenosum is a destructive cutaneous disorder characterized by painful, rapidly enlarging ulcers with under-mined bluish and purplish red margins. This disease is most frequently found in association with ulcerative colitis. However, in the last three years, four cases of pyoderma gangrenosum precipitated by surgical procedures have occurred, and only one of these patients had ulcerative colitis. All four patients responded to steroid therapy and local wound care. Pyoderma gangrenosum can first be suspected by recognition of the previously described classic lesion. In addition, the absence of significant microbial growth and the lack of a specific etiology ascertained on routine and special staining of biopsy material is suggestive of the diagnosis. Histologic characteristics are entirely nonspecific but can be helpful in ruling out other specific entities. The progressively destructive nature of this process in the face of what would seem to be appropriate therapy for bacterial wound infection requires that pyoderma gangrenosum, as well as other aspects of the differential diagnosis of a persistent ulcerative lesion, such as fungal infection, factitious ulcer, or vasculitis, be considered.
坏疽性脓皮病是一种破坏性皮肤疾病，其特征为疼痛、迅速扩大的溃疡，边缘呈潜行性蓝紫色和紫红色。这种疾病最常与溃疡性结肠炎相关。然而，在过去三年中，出现了4例因外科手术诱发的坏疽性脓皮病病例，其中只有1例患者患有溃疡性结肠炎。所有4例患者对类固醇治疗和局部伤口护理均有反应。通过识别上述典型病变可首先怀疑坏疽性脓皮病。此外，活检材料常规及特殊染色未发现明显微生物生长且未确定特定病因提示该诊断。组织学特征完全不具有特异性，但有助于排除其他特定疾病。面对看似适用于细菌性伤口感染的治疗方法，该疾病仍具有进行性破坏性，这就需要考虑坏疽性脓皮病以及持续性溃疡性病变鉴别诊断的其他方面，如真菌感染、人为溃疡或血管炎。
