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[坏疽性脓皮病作为髓系白血病的前驱病变]

[Pyoderma gangrenosum as a precursor of myeloid leukemia].

作者信息

Maier H, Diem E, Gotschim A, Ortel B

机构信息

Abteilung für Spezielle Dermatologie und Umweltdermatosen, Universität, Wien.

出版信息

Hautarzt. 1995 Sep;46(9):647-50. doi: 10.1007/s001050050313.

Abstract

A 34-year-old woman who was 20 weeks pregnant developed pyoderma gangrenosum while receiving treatment for infarct pneumonia. Because of her septic condition an abortion was performed. The patient received intravenous prednisolone as a pulse treatment for her pyoderma gangrenosum, which was followed by oral methylprednisolone and oral dapsone for 6 weeks. After dose reduction the patient had a severe relapse. The steroid dose was increased and dapsone was replaced by cyclosporin A. The smaller ulcers healed spontaneously, but skin grafting had to be performed for the large ulcer. The steroid therapy was tapered and discontinued. Cyclosporin A was continued for 10 weeks as monotherapy. Subsequently, the patient was free of symptoms for 7 months. Twelve months after the diagnosis of pyoderma gangrenosum the patient developed acute myeloid leukaemia accompanied by a recurrence of the skin disease.

摘要

一名34岁、孕20周的女性在接受梗死性肺炎治疗时发生了坏疽性脓皮病。由于她的败血症状况,进行了人工流产。患者接受静脉注射泼尼松龙作为坏疽性脓皮病的冲击治疗,随后口服甲泼尼龙和口服氨苯砜6周。减量后患者出现严重复发。增加了类固醇剂量,并用环孢素A替代了氨苯砜。较小的溃疡自发愈合,但大溃疡不得不进行皮肤移植。逐渐减少并停用了类固醇疗法。环孢素A作为单一疗法持续使用了10周。随后,患者7个月无症状。坏疽性脓皮病诊断12个月后,患者发生急性髓系白血病并伴有皮肤病复发。

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