Schultz E S, Diepgen T L, von den Driesch P, Hornstein O P
Department of Dermatology, Friedrich-Alexander-University Erlangen-Nuremberg, Germany.
Br J Dermatol. 1995 Oct;133(4):633-5. doi: 10.1111/j.1365-2133.1995.tb02719.x.
Fournier's gangrene represents an acute severe necrotizing inflammatory process affecting the scrotum and penis. It has an associated mortality of 30-50%. In most cases, aetiological factors can be identified, such as diabetes mellitus, chronic alcoholism and perianal, perirectal or periurethral infection. The disease is characterized by a polybacterial infection, and the classic treatment includes surgical removal of the necrotic tissue and the use of broad-spectrum antibiotics. We report a case of Fournier's gangrene, histologically characterized by a necrotizing vasculitis, in which surgical resection of the necrotic tissue and antibiotic treatment failed to halt progression of the disease, whereas complete remission was achieved by high-dose corticosteroid therapy. This suggests that Fournier's gangrene is related to some form of localized vasculitis, and represents a local Shwartzman phenomenon.
福尼尔坏疽是一种影响阴囊和阴茎的急性严重坏死性炎症过程。其相关死亡率为30%至50%。在大多数情况下，可以确定病因，如糖尿病、慢性酒精中毒以及肛周、直肠周围或尿道周围感染。该病的特征是多细菌感染，经典治疗方法包括手术切除坏死组织和使用广谱抗生素。我们报告一例福尼尔坏疽病例，组织学特征为坏死性血管炎，其中手术切除坏死组织和抗生素治疗未能阻止疾病进展，而高剂量皮质类固醇治疗实现了完全缓解。这表明福尼尔坏疽与某种形式的局部血管炎有关，代表了局部施瓦茨曼现象。
