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Abstract

Pyoderma gangrenosum (PG) is a serious skin lesion which may accompanying numerous diseases and it can cause of painful, and recurrent ulcer. The lesions may arise as single or multiple lesions secondary to systemic diseases such as ulcerative colitis, Crohn’s disease, polyarthritis, monoclonal gammopathy or spontaneously without any underlying disease. A 25-year-old male patient was admitted with complaints of fever, abdominal pain, bloody diarrhea, painful and infected deep ulcers on head, trunk and extremities. Rectosigmoidoscopy was performed eight days ago and biopsies on sigmoid colon mucosa from the ulcerated lesions were taken because of suspected from ulcerative colitis (UC). Mesalazine and fluocortolone was initiated with diagnosis of UC and PG. Complaints of patient and colonic and skin lesions rapidly regressed. An amputation of his right foot’s on 3rd finger and skin graft operations for skin defects on his right arm and right leg was performed three months later. He was discharged from the hospital with improved symptoms. Here, we aimed to emphasis the importance of PG in differential diagnosis in patients who was admitted to hospital with skin abscess and skin ulcers which seem like to be infected

Keywords

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MESALAZİN VE STEROİD İLE TEDAVİ EDİLEN PYODERMA GANGRENOZUMUN EŞLİK ETTİĞİ ÜLSERATİF KOLİT VAKASI

Öz

Pyoderma gangrenozum (PG), çok çeşitli hastalıklarla birlikte olabilen, ağrılı ve rekürren derin ülserasyonlarla seyredebilen ciddi bir deri lezyonudur. Lezyonlar, ülseratif kolit, Crohn hastalığı, poliartrit, monoklonal gammopati gibi sistemik hastalıklarla birlikte veya altta yatan bir hastalık olmaksızın tek veya çok sayıda görülebilirler. 25 yaşında erkek hasta, ateş, karın ağrısı, kanlı ishal ve alında, gövde ve ekstremitelerde yaygın ağrılı, enfekte ve derin ülserlerle başvurdu. Hastaya 8 gün önce rektosigmoidoskopi yapılmıştı ve ülseratif kolitten (ÜK) şüphelenilmişti ve sigmoid kolondaki ülsere lezyonlardan biyopsi alınmıştı. Hastaya ÜK ve PG teşhisiyle mesalazine ve fluocortolone başlandı. Hastanın şikayetleri, barsak ve deri lezyonları hızla geriledi. 3 ay sonra sağ ayak 3. parmağa amputasyon ve sağ koldaki ve sağ bacaktaki cilt defektleri için greft operasyonu yapıldı. Hasta şifa ile taburcu edildi. Biz bu vakayı, apse ve infekte görünümlü deri ülserleriyle gelen hastada PG’nin, ayırıcı tanıdaki yerini vurgulamak amacıyla rapor ettik

Anahtar Kelimeler

• Fluocortolone, mesalazin, pyoderma gangrenozum, ülseratif kolit

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