Micali G, Cook B, Ronan S, Yadgir J, Solomon L M
Department of Dermatology, University of Illinois, Chicago Abraham Lincoln School of Medicine.
Int J Dermatol. 1994 Jul;33(7):477-80. doi: 10.1111/j.1365-4362.1994.tb02858.x.
Pyoderma gangrenosum (PG)-like lesions can be associated with Wegener's granulomatosis (WG); in rare instances, they could be the presenting sign of WG. The purpose of this study was to elucidate the relationship between these two disorders.
The clinical and histologic data from a case of WG with primary ulcerative lesions of the face were compared with five other cases previously reported in the literature.
A predominance among young men was noted. In three patients the histology of the skin ulcerations was suggestive of WG, in the remaining three, including the case described, it was nonspecific. Two cases developed pulmonary WG after the skin lesions cleared, showing that the extent and severity of skin lesions do not necessarily correlate with the systemic disease.
When the histology of the skin is nonspecific, the diagnosis of PG or PG-like lesions of the head and neck should not be considered definitive and the patients should be carefully monitored to rule out the possible presence of WG.
坏疽性脓皮病（PG）样病变可能与韦格纳肉芽肿病（WG）相关；在罕见情况下，它们可能是WG的首发症状。本研究的目的是阐明这两种疾病之间的关系。
将1例面部原发性溃疡性病变的WG患者的临床和组织学数据与文献中先前报道的其他5例病例进行比较。
发现男性年轻人居多。3例患者皮肤溃疡的组织学表现提示为WG，其余3例（包括所描述的病例）为非特异性表现。2例患者在皮肤病变消退后出现肺部WG，表明皮肤病变的范围和严重程度不一定与全身性疾病相关。
当皮肤组织学表现为非特异性时，不应将头颈部PG或PG样病变的诊断视为定论，应仔细监测患者以排除可能存在的WG。
