Atypical presentation of pioderma gangrenosum complicating ulcerative colitis: Rapid disappearance with methylprednisolone

被引:13
作者
Aseni, Paolo [1 ]
Di Sandro, Stefano [1 ]
Mihaylov, Plamen [1 ]
Lamperti, Luca [1 ]
De Carlis, Luciano Gregorio [1 ]
机构
[1] Osped Niguarda Ca Granda, Liver Transplantat Ctr, I-20162 Milan, Italy
关键词
ulcerative colitis; pioderma gangrenosum; steroids; cutaneous lesion; immunosuppression;
D O I
10.3748/wjg.14.5471
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Piodermal gangrenosum (PG) is an uncommon ulcerative cutaneous dermatosis associated with a variety of systemic diseases, including inflammatory bowel disease (IBD), arthritis, leukaemia, hepatitis, and primary billiary cirrhosis. Other cutaneous ulceration resembling PG had been described in literature. There has been neither laboratory finding nor histological feature diagnostic of PG, and diagnosis of PG is mainly made based on the exclusion criteria. We present here a patient, with ulcerative colitis (UC) who was referred to the emergency section with a large and rapidly evolving cutaneous ulceration. Laboratory and microbiological investigation associated with histological findings of the ulcer specimen allowed us to exclude autoimmune and systemic diseases as well as immuno-proliferative disorders. An atypical presentation of PG with UC was diagnosed. Pulse boluses of i.v. methyl-prednisolone were started, and after tapering steroids, complete resolution of the skin lesion was achieved in 3 wk. The unusual rapid healing of the skin ulceration with steroid mono-therapy and the atypical cutaneous presentation in this patient as well as the risk of misdiagnosis of PG in the clinical practice were discussed. (C) 2008 The WJG Press. All rights reserved.
引用
收藏
页码:5471 / 5473
页数:3
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