BibTex RIS Kaynak Göster

A rare complication of ulcerative colitis: Pyoderma gangrenosum

Yıl 2011, Cilt: 10 Sayı: 2, 87 - 90, 01.08.2011

Öz

Pyoderma gangrenosum is a rare inflammatory skin illness characterized by ulcers. It can be seen with unknown etiology or with some systemic disorders such as ulcerative colitis, Crohn's disease and monoclonal gammopathy. Ulcers may be seen as single or multiple. We present in this article a pyoderma gangrenosum case that occurred with the activation of ulcerative colitis. A 21-year-old male was admitted to our hospital with a one-month history of symptoms of bloody and mucoid defecation with general intense body pain, ulcers (some with purulent secretion) and necrotic wounds. Rectosigmoidoscopy showed active state ulcerative colitis, and this diagnosis was confirmed with biopsies. Amebiasis was excluded with stool examination. After exclusion of infectious causes with gram staining and culture, the patient was diagnosed as pyoderma gangrenosum with histopathological findings. We started high-dose corticosteroid with the diagnosis of pyoderma gangrenosum and ulcerative colitis. Symptoms and findings significantly regressed in 10 days and totally healed in three months. In conclusion, pyoderma gangrenosum (which rarely occurs and usually does not correlate with the disease activity) can be seen with disease activity and may heal with high-dose steroid treatment in a short time.

Kaynakça

  • Powell FC, Schroeter AL, Su WP, Perry HO. Pyoderma gangrenosum: a review of 86 patients. Q J Med 1985; 5: 173-86.
  • Futami H, Kodaira M, Furuta T, et al. Pyoderma gangrenosum complicating ulcerative colitis: successful treatment with methylprednisolone pulse therapy and cyclosporine. J Gastroenterol 1998; 33: 408 -11.
  • Brunsting LA, Underwood LJ. Pyoderma vegetans in association with chronic ulcerative colitis. Arch Derm Syphilol 1949; 60: 161-72.
  • Abdelrazeq AS, Lund JN, Leveson SH. Pouchitis-associated pyoderma gangrenosum following restorative proctocolectomy for ulcerative colitis. Eur J Gastroenterol Hepatol 2004; 16: 1057-8.
  • Weismann K, Graham RM. Systemic disease and the skin. In:Rook’s Textbook of Dermatology. 6th edition. Blackwell Science Limited; 1998. p. 2721-3.
  • Ahmadi S, Powell FC. Pyoderma gangrenosum: uncommon presentations. Clin Dermatol 2005; 23: 612-20.
  • Powell FC, Su WP, Perry HO. Pyoderma gangrenosum: classification and management. J Am Acad Dermatol 1996; 34: 395-409.
  • Sampson JA, Harris OD, Van Deth AG. Pyoderma gangrenosum and chronic active hepatitis: a case report. Australas J Dermatol 1982; 23: 93-6.
  • Cox NH, Peebles-Brown DA, MacKie RM. Pyoderma gangrenosum occuring 10 years after proctocolectomy for ulcerative colitis. Br J Hosp Med 1986; 36: 363.
  • Tafldelen-F›flg›n N, Ayd›n F, Tanyel E, et al. Pyoderma gangrenosum. Klimik Dergisi 2006; 19: 82-4.
  • Abela CB, Soldin M, Gateley D. Pyoderma gangrenosum-Case report. Br J Oral Maxillofac Surg 2007; 45: 328-30.
  • Eichhorn PJ. Pyoderma gangrenosum. Dermatol Ther 2001; 14:102 -10.
  • Chow RK, Ho VC. Treatment of pyoderma gangrenosum. J Am Acad Dermatol 1996; 34: 1047 -60.
  • Petering H, Kiehl P, Breuer C, et al. Pyoderma gangrenosum: succesful topical therapy with tacrolimus (FK 506). Hautarzt 2001; 52:47-50 .
  • Goreti Catorze M, Pereira F, Fonseca F, et al. Pyoderma gangrenosum associated with sclerosing choloangitis, type 1 diabetes mellitus and ulcerative colitis. J Eur Acad Dermatol Venereol 2001; 15:257-9.
  • Hughes AP, Jackson JM, Callen JP. Clinical features and treatment of peristomal pyoderma gangrenosum. JAMA 2000; 284: 1546-8.
  • Stone OJ. Sulfapyridine and sulfones decreasa glycosaminoglycans viscosity in dermatitis herpetiforms, ulcerative colitis, and pyoderma gangrenosum. Med Hypotheses 1990; 31: 99-103.
  • Belaube P, Garcin G, Marchand JP, Privat Y. Should thalidomide be rehabilitated? Sem Hop 1983; 59: 3101-4.
  • Gerard A, Schooneman F,Voiriot P at all. Pyoderma gangrenosum: treatment with plasma exchange (4 cases). Ann Med Interne (Paris) 1998;139 Suppl 1:29-31.

Nadir görülen bir ülseratif kolit komplikasyonu: Piyoderma gangrenosum

Yıl 2011, Cilt: 10 Sayı: 2, 87 - 90, 01.08.2011

Öz

Pyoderma gangrenosum, nadir görülen, ülserlerle karakterize, inflamatuvar bir deri hastalığıdır. Lezyonlar, ülseratif kolit, Crohn hastalığı, monoklonal gammopati gibi sistemik hastalıklarla birlikte veya altta yatan hastalık olmaksızın tek başına görülebilir. Bu makalede ülseratif kolitin aktivite kazanması ile ortaya çıkan yaygın pyoderma gangrenosum olgusunu sunduk. 21 yaşında erkek hasta, 1 aydır kanlı mukuslu dışkılama ile birlikte tüm vücutta yaygın ve şiddetli ağrılı, bazıları pürülan ve akıntılı ülserler ve nekrotik yaralarla kliniğimize başvurdu. Rektosigmoidoskopide aktif evre ülseratif kolit saptandı ve alınan biyopsilerle ülseratif kolit tanısı tekrar doğrulandı. Gaytanın mikroskopik incelemesi ile amibiazis ekarte edildi. Gram boyama ve kültür sonucu ile enfeksiyöz nedenler dışlandıktan sonra klinik ve histopatolojik bulgularla pyoderma gangrenosum tanısı konuldu. Olguya pyoderma gangrenosum ve ülseratif kolit tanısıyla 80 mg/gün metilprednisolon başlandı. Semptom ve bulgular 10 günde büyük oranda, 3 haftada ise tamamen düzeldi. Sonuç olarak, ülseratif kolitte nadir olarak görülen ve genellikle hastalık aktivitesinden bağımsız olarak seyreden pyoderma gangrenosum, hastalığın aktivitesi ile birlikte de ortaya çıkabilmekte ve yüksek doz steroid tedavisiyle de kısa sürede iyileşebilmektedir.

Kaynakça

  • Powell FC, Schroeter AL, Su WP, Perry HO. Pyoderma gangrenosum: a review of 86 patients. Q J Med 1985; 5: 173-86.
  • Futami H, Kodaira M, Furuta T, et al. Pyoderma gangrenosum complicating ulcerative colitis: successful treatment with methylprednisolone pulse therapy and cyclosporine. J Gastroenterol 1998; 33: 408 -11.
  • Brunsting LA, Underwood LJ. Pyoderma vegetans in association with chronic ulcerative colitis. Arch Derm Syphilol 1949; 60: 161-72.
  • Abdelrazeq AS, Lund JN, Leveson SH. Pouchitis-associated pyoderma gangrenosum following restorative proctocolectomy for ulcerative colitis. Eur J Gastroenterol Hepatol 2004; 16: 1057-8.
  • Weismann K, Graham RM. Systemic disease and the skin. In:Rook’s Textbook of Dermatology. 6th edition. Blackwell Science Limited; 1998. p. 2721-3.
  • Ahmadi S, Powell FC. Pyoderma gangrenosum: uncommon presentations. Clin Dermatol 2005; 23: 612-20.
  • Powell FC, Su WP, Perry HO. Pyoderma gangrenosum: classification and management. J Am Acad Dermatol 1996; 34: 395-409.
  • Sampson JA, Harris OD, Van Deth AG. Pyoderma gangrenosum and chronic active hepatitis: a case report. Australas J Dermatol 1982; 23: 93-6.
  • Cox NH, Peebles-Brown DA, MacKie RM. Pyoderma gangrenosum occuring 10 years after proctocolectomy for ulcerative colitis. Br J Hosp Med 1986; 36: 363.
  • Tafldelen-F›flg›n N, Ayd›n F, Tanyel E, et al. Pyoderma gangrenosum. Klimik Dergisi 2006; 19: 82-4.
  • Abela CB, Soldin M, Gateley D. Pyoderma gangrenosum-Case report. Br J Oral Maxillofac Surg 2007; 45: 328-30.
  • Eichhorn PJ. Pyoderma gangrenosum. Dermatol Ther 2001; 14:102 -10.
  • Chow RK, Ho VC. Treatment of pyoderma gangrenosum. J Am Acad Dermatol 1996; 34: 1047 -60.
  • Petering H, Kiehl P, Breuer C, et al. Pyoderma gangrenosum: succesful topical therapy with tacrolimus (FK 506). Hautarzt 2001; 52:47-50 .
  • Goreti Catorze M, Pereira F, Fonseca F, et al. Pyoderma gangrenosum associated with sclerosing choloangitis, type 1 diabetes mellitus and ulcerative colitis. J Eur Acad Dermatol Venereol 2001; 15:257-9.
  • Hughes AP, Jackson JM, Callen JP. Clinical features and treatment of peristomal pyoderma gangrenosum. JAMA 2000; 284: 1546-8.
  • Stone OJ. Sulfapyridine and sulfones decreasa glycosaminoglycans viscosity in dermatitis herpetiforms, ulcerative colitis, and pyoderma gangrenosum. Med Hypotheses 1990; 31: 99-103.
  • Belaube P, Garcin G, Marchand JP, Privat Y. Should thalidomide be rehabilitated? Sem Hop 1983; 59: 3101-4.
  • Gerard A, Schooneman F,Voiriot P at all. Pyoderma gangrenosum: treatment with plasma exchange (4 cases). Ann Med Interne (Paris) 1998;139 Suppl 1:29-31.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Hatice Şule Akın Bu kişi benim

Adil Coşkun Bu kişi benim

Pınar Karatay Bu kişi benim

Ekin Savk Bu kişi benim

Mehmet Hadi Yaşa Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2011
Yayımlandığı Sayı Yıl 2011 Cilt: 10 Sayı: 2

Kaynak Göster

APA Akın, H. Ş., Coşkun, A., Karatay, P., Savk, E., vd. (2011). Nadir görülen bir ülseratif kolit komplikasyonu: Piyoderma gangrenosum. Akademik Gastroenteroloji Dergisi, 10(2), 87-90.

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