Pyoderma gangrenosum as a manifestation of leukemia in childhood

Pyoderma gangrenosum is an uncommon skin lesion often associated with autoimmune diseases. A clear association between leukemia and pyoderma gangrenosum in adults has been established. Two cases of pyoderma gangrenosum in children with leukemia in whom it may be an initial finding are presented.     

Takayasu's disease in a 14 years old girl

Takayasu's disease is a chronic, nonspecific arteritis of unknown etiology. It mainly affects young women in the second and third decade of life. The reports of the disease in pediatric patients are rare. The pathological process involves all the layers of the arterial wall. It affects primarily the aortic arch and its main branches. If the renal arteries are involved, hypertension develops. A 14-year-old girl suffered from Takayasu's disease was described. The first symptoms: tonic-clonic seizures, neurological signs and high arterial blood pressure were observed in a previously healthy girl. The diagnostics process was presented with special attention given to the interpretation of radiological imagings. The diagnosis of Takayasu's disease was based on result of angiography. This examination demonstrated the abdominal aorta abnormalities which have been described in patients with Takayasu's disease and the right renal artery stenosis.     

Pyoderma gangrenosum in a six-month-old boy

Pyoderma gangrenosum (PG) is an uncommon, chronic ulcerative condition of the skin that was first described in 1930. It can occur in any age group, but only 4% of the patients are infants or children. An underlying systemic disease is present in approximately 50% of the patients with PG. The most common associations include inflammatory bowel disease, arthritis, lymphoproliferative disorders and chronic recurrent multifocal osteomyelitis (CRMO). PG has been reported in association with CRMO in only a few children whose ages were between 18 months and 12 years. We report a six-month-old boy who was diagnosed as CRMO based on his clinical examination and histological findings. This is the youngest case reported in the literature (under 12 months of age) with PG associated with CRMO.     

Pyoderma gangrenosum in acute myeloid leukaemia during immunosuppression

We describe a patient who developed pyoderma gangrenosum during the remission phase of acute myeloid leukaemia whilst receiving maintenance therapy with methotrexate and 6-mercaptopurine. The spontaneous resolution of these skin lesions following discontinuation of chemotherapy suggests that these drugs may be of major significance in the aetiology of pyoderma gangrenosum. Nevertheless, 27 months later, a relapse of the leukaemia followed. Although pyoderma gangrenosum occurred during clinical remission, we cannot rule out a synergism of leukaemia and chemotherapy in its pathogenesis.Abbreviations PG pyoderma gangrenosum - AML acute myeloid leukaemia - 6MP 6-mercaptopurine - MTX methotrexate - AP acute pancytopenia - IT induction therapy - MT maintenance therapy     

15岁女孩突发抽搐并肺部多发结节

15岁女童因抽搐1次,同时肺部CT发现肺结节入院.无肢端发绀,无明显杵状指/趾畸形.实验室检查示血红蛋白升高(162 g/L)、动脉血氧分压降低(61.5 mm Hg).肺部CT提示右肺中叶见不规则稍高密度结节,增强扫描可见明显强化,局部见粗大血管影.追问病史发现患儿母亲有鼻衄、肺部肿物切除史及舌部毛细血管扩张表现.患...     

Sensorineural hearing loss as an extra-intestinal manifestation of ulcerative colitis in an adolescent girl with pyoderma gangrenosum

Inflammatory bowel disease is becoming increasingly frequent in children of all ages. In addition to the usual gastrointestinal stigmata of weight loss, anaemia, and rectal bleeding, children may exhibit prominent extra-intestinal manifestations such as joint symptoms, skin signs and some other auto-immune manifestations. Here we present a 15-year-old girl with ulcerative colitis in whom pyoderma gangrenosum and acute sensorineural hearing loss developed. Conclusion: although pyoderma gangrenosum is well described with inflammatory bowel disease, sensorineural hearing loss a is very unusual finding, possibly of auto-immune aetiology. We recommend steroid or immunosuppressive therapy in such a patient.