15例坏疽性脓皮病临床分析

目的为进一步了解坏疽性脓皮病的临床资料、组织病理特点及治疗方法。方法对15例坏疽性脓皮病(PG)患者进行回顾性分析。结果 15例确诊患者中男9例,女6例,男∶女为1.5∶1;溃疡型PG有10例(66.67%),并发的相关内科疾病有类风湿关节炎、溃疡性结肠炎、慢性乙型肝炎、肺部感染、重度贫血。对溃疡周围卫星灶非溃疡皮损行组织病理检查,发现明显的血管炎性组织病理改变。结论溃疡型PG为其主要临床类型,不同部位取材其组织病理表现不同,沙利度胺联合环磷酰胺治疗PG有效,且随访复发率较低。     

坏疽性脓皮病19例临床分析

目的:提高对坏疽性脓皮病(PG)的认识,探讨其最有效的治疗方法。方法:对1994—2004年在我科住院的19例PG患者的临床资料进行回顾性分析。结果:该病发病年龄以45岁以上居多;PG除有皮肤损害外,还可累及其他器官。约42.1%的患者并发有系统性疾病,其中以并发糖尿病居多。实验室检查结果和组织病理改变无特异性。结论:PG是一种少见的皮肤病,主要根据其临床特点诊断。目前,糖皮质激素是控制PG最有效的药物,亦可联合应用免疫抑制剂、磺胺类、米诺环素等药物,局部治疗有利于皮损愈合。     

坏疽性脓皮病11例临床分析报告

报告１１例坏疽性脓皮病，均有不同程度皮肤损害，伴发热等全身症状和其它脏器累及，其中以肺部累及较为突出。对本病的治疗应在了解全身病情的基础上以全身使用皮质类固醇激素为主，控制剂量相当于强地松０．５￣１ｍｇ（ｋｇ．ｄ），必要时辅助应用免疫抑制剂，及时处理并发症。全身用抗生素只有辅助作用，局部治疗有利于控制感染和促进皮损愈合。     

Pustular pyoderma gangrenosum

A 79-year-old woman was admitted to our hospital with pustular pyoderma gangrenosum and an associated IgG kappa monoclonal gammopathy. The patient is currently being evaluated for possible multiple myeloma. IgG multiple myeloma and IgG monoclonal gammopathies are very rare in patients with pyoderma gangrenosum. The skin lesions are improving with the use of prednisone.     

Penile pyoderma gangrenosum

We present a case of penile pyoderma gangrenosum (PG) that responded dramatically to an 8-week course of prednisone and has not recurred over a 6-month period. Although quite uncommon, penile PG should be a diagnostic consideration in any patient with non-healing ulcerative lesions of the penis. A correct diagnosis in this situation precludes unnecessary or harmful therapeutic interventions and leads to proper management.     

Penile pyoderma gangrenosum

Pyoderma gangrenosum is a rare ulcerating inflammatory skin disease. Genital involvement has been rarely reported. We report a 24-year-old man with penile pyoderma gangrenosum who was treated with systemic corticosteroids.     

Pustular pyoderma gangrenosum

Pyoderma gangrenosum (PG) is an idiopathic inflammatory disease of unknown aetiology, frequently associated with an underlying systemic condition such as inflammatory bowel disease or haematological malignancy. Its occurrence tends to parallel exacerbations of the underlying disease. Four clinical variants of PG have been described and these include ulcerative, pustular, bullous and vegetative types. We report two cases of the pustular form, which is an uncommon variant of PG, where the pustules do not progress to form ulcers. Both our patients suffered with inflammatory bowel disease which remained quiescent as the pustular PG developed.     

Treatment of pyoderma gangrenosum

Critical to the proper management of pyoderma gangrenosum are correct diagnosis, identification and treatment of any underlying disorder, and the proper choice of topical and systemic therapy. Many agents are available for the treatment of pyoderma gangrenosum. We review the current therapeutic options, their efficacy and side effects, and we offer some guidelines for their proper selection.     

Management of pyoderma gangrenosum

The management of pyoderma gangrenosum (PG) requires a structured approach to establishing diagnosis of the disease and assessment of the patient. Clinical management of active PG lesions should be carried out in coordination with other specialists (such as nurses and pain managers) and often necessitates a flexible, innovate attitude to therapy, because the needs of individual patients may vary widely. Although there is no single successful treatment for this disease, certain types of PG lesions are recognized to respond more readily to accepted therapies than others. We outline guidelines to the management of the patient with PG and discuss alternative therapies.     

Treatment of pyoderma gangrenosum with cyclosporine.

BACKGROUND AND DESIGN--Pyoderma gangrenosum is a chronic inflammatory ulcerative skin disease of unknown origin, often associated with various diseases including inflammatory bowel disease, inflammatory arthritis, monoclonal gammopathies, hepatitis, and myeloproliferative disorders. Treatment of associated systemic disorders may improve the ulcers, but lesions may be recalcitrant and persist for months to years. Therapy for pyoderma gangrenosum includes high-dose systemic corticosteroids, sulfa drugs such as sulfasalazine, clofazimine, and immunosuppressive agents such as mercaptopurine and azathioprine; these drugs are sometimes ineffective. RESULTS--We present a series of 11 patients with pyoderma gangrenosum, with a wide range of underlying diseases, whose ulcers were refractory to usual therapy and who were treated with low-dose cyclosporine. Ten of the 11 patients cleared rapidly and completely with cyclosporine therapy. CONCLUSIONS--Cyclosporine should be seriously considered as a primary form of treatment for pyoderma gangrenosum.