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Two Cases of Pyoderma Gangrenosum Associated with Recurrent Ulcerative Colitis  

Kwon, Yong-Hwan (Department of Internal Medicine, Yonsei University Wonju College of Medicine)
Kim, Jae-Woo (Department of Internal Medicine, Yonsei University Wonju College of Medicine)
Park, So-Yeon (Department of Internal Medicine, Yonsei University Wonju College of Medicine)
Kim, Moon-Young (Department of Internal Medicine, Yonsei University Wonju College of Medicine)
Kim, Hyun-Soo (Department of Internal Medicine, Yonsei University Wonju College of Medicine)
Baik, Soon-Koo (Department of Internal Medicine, Yonsei University Wonju College of Medicine)
Abdul-Ghafar, Jamshid (Department of Pathology, Yonsei University Wonju College of Medicine)
Cho, Mee-Yon (Department of Pathology, Yonsei University Wonju College of Medicine)
Publication Information
Clinical Endoscopy / v.41, no.5, 2010 , pp. 312-318 More about this Journal
Abstract
Pyoderma gangrenosum (PG) begins with a painful, erythematous skin lesion followed by pustule formation and rapid ulceration in which an erythematous border surrounds a sterile, necrotic center. In most patients, symptoms of ulcerative colitis precede PG, and exacerbations of the bowel disease frequently correlate with worsening of the skin lesions. As PG is not commonly encountered by clinicians, the diagnosis of such lesions is not always straightforward. This case emphasizes the importance of detailed history taking and the consideration of PG as a differential diagnosis of such lesions in patients with a background of related systemic disease. The prognosis of PG is generally good. But, early aggressive therapy can minimize severe complications, and maintenance treatment may prevent some devastating consequences. We report two cases of PG that developed on the entire body and on an anterior chest wall abscess with ulcerative colitis, which improved with corticosteroid and cyclosporine.
Keywords
Pyoderma gangrenosum; Ulcerative colitis; Corticosteroid; Cyclosporine;
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1 Funayama Y, Kumagai E, Takahashi K, Fukushima K, Sasaki I. Early diagnosis and early corticosteroid administration improves healing of peristomal pyoderma gangrenosum in inflammatory bowel disease. Dis Colon Rectum 2009;52:311-314.   DOI   ScienceOn
2 Regueiro M, Valentine J, Plevy S, Fleisher MR, Lichtenstein GR. Infliximab for treatment of pyoderma gangrenosum associated with inflammatory bowel disease. Am J Gastroenterol 2003;98:1821-1826.   DOI   ScienceOn
3 Ruocco E, Sangiuliano S, Gravina AG, Miranda A, Nicoletti G. Pyoderma gangrenosum: an updated review. J Eur Acad Dermatol Venereol 2009;23:1008-1017.   DOI   ScienceOn
4 Jung SA, Yang SK, Jung HY, et al. Two cases of pyoderma gangrenosum associated with inflammatory bowel disease. Korean J Gastrointest Endosc 1997;17:847-852.
5 Kim DH, Oh JH, Lee JJ, Kim HJ. A case of pyoderma gangrenosum on the nasal dorsum. Arch Otolaryngol Head Neck Surg 2010;136:193-196.   DOI   ScienceOn
6 Park CH, Chun HJ, Jeen YT, et al. Pyoderma gangrenosum on the sternal area in ulcerative colitis. Korean J Gastrointest Endosc 2002;25:470-474.
7 Aseni P, Di Sandro S, Mihaylov P, Lamperti L, De Carlis LG. Atypical presentation of pyoderma gangrenosum complicating ulcerative colitis: rapid disappearance with methylprednisolone. World J Gastroenterol 2008;14:5471-5473.   DOI   ScienceOn
8 Callen JP. Pyoderma gangrenosum. Lancet 1998;351:581-585.   DOI   ScienceOn
9 Ermis F, Ozdil S, Akyuz F, Pinarbasi B, Mungan Z. Pyoderma gangrenosum treated with infliximab in inactive ulcerative colitis. Inflamm Bowel Dis 2008;14:1611-1613.   DOI   ScienceOn
10 Cho HL, Chang YW, Cho YS, et al. A case of pyoderma gangrenosum associated with inactive ulcerative colitis. Korean J Gastrointest Endosc 1998;18:597-603.
11 Seo HD, Na CH, Chung BS, Choi KC, Shin BS. A case of post-traumatic pyoderma gangrenosum associated with ulcerative colitis. Korean J Dermatol 2008;46:487-490.
12 Menachem Y, Gotsman I. Clinical manifestations of pyoderma gangrenosum associated with inflammatory bowel disease. Isr Med Assoc J 2004;6:88-90.
13 Seok JH, Park JC, Kwun SW, et al. Pyoderma gangrenosum in ulcerative colitis. Korean J Gastrointest Endosc 1999;19:300-305.
14 Okuma K, Mitsuishi K, Hasegawa T, Tsuchihashi H, Ogawa H, Ikeda S. A case report of steroid and immunosuppressantresistant pyoderma gangrenosum successfully treated by granulocytapheresis. Ther Apher Dial 2007;11:387-390.   DOI   ScienceOn
15 Brooklyn TN, Dunnill MG, Shetty A, et al. Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial. Gut 2006;55:505-509.   DOI   ScienceOn
16 Papageorgiou KI, Mathew RG, Kaniorou-Larai MG, Yiakoumetis A. Pyoderma gangrenosum in ulcerative colitis: considerations for an early diagnosis. BMJ 2005;331:1323-1324.   DOI   ScienceOn
17 Yuksel I, Basar O, Ataseven H, et al. Mucocutaneous manifestations in inflammatory bowel disease. Inflamm Bowel Dis 2009;15:546-550.   DOI   ScienceOn
18 Veloso FT. Review article: skin complications associated with inflammatory bowel disease. Aliment Pharmacol Ther 2004;20(suppl 4):50S-53S.
19 Johnson ML, Wilson HT. Skin lesions in ulcerative colitis. Gut 1969;10:255-263.   DOI   ScienceOn
20 Futami H, Kodaira M, Furuta T, Hanai H, Kaneko E. Pyoderma gangrenosum complicating ulcerative colitis: successful treatment with methylprednisolone pulse therapy and cyclosporine. J Gastroenterol 1998;33:408-411.   DOI   ScienceOn