Recalcitrant pyoderma gangrenosum treated with systemic tacrolimus

Paraffin-based emollients are widely used in dermatological practice and are not usually absorbed through the skin. We report a case where transcutaneous transfer did occur in the context of damaged skin in Netherton's syndrome, resulting in a reversible lymphadenopathy.     

A case of cytomegalovirus colitis following immunosuppressive treatment for pyoderma gangrenosum

We report a case of pyoderma gangrenosum (PG) complicated by cytomegalovirus (CMV)-induced colitis. A 79-year-old woman with PG was treated with corticosteroid and cyclosporin. She had blood in her stool and advancing anemia during the treatment. A colonoscopic biopsy specimen from the colon revealed typical CMV-infected cells with CMV inclusions confirmed by immunohistochemistry. Furthermore, there were many CMV-antigen-positive leukocytes, suggesting an active CMV infection, which is serious in compromised hosts. Although ulcerative colitis and Crohn's disease are well known as complications of PG, CMV enterocolitis should be considered in the differential diagnosis of enterocolitis in immunocompromised patients.     

坏疽性脓皮病一例

<正>临床资料患者,女,20岁。主因双下肢反复溃烂4年,累及上肢1个月余,于2013年7月23日入院。4年前患者右小腿因蚊虫叮咬后出现一绿豆大小红色丘疹伴瘙痒,反复搔抓后皮损破溃、结痂,未诊治。之后3年患者就诊多家医院,考虑为"脓疱疮、湿疹",多种药物(具体不详)治疗无效,原皮损面积逐渐扩大,漫延至左下肢。期间双下肢皮损反复出现"面积增大-破溃-溢脓-结痂"过程。2013年3月,因     

Treatment of refractory pyoderma gangrenosum with intravenous immunoglobulin

We report a patient with pyoderma gangrenosum successfully treated with intravenous immunoglobulin. He had previously been treated for 4 years with high-dose corticosteroids and had developed insulin-dependent diabetes mellitus. Multiple corticosteroid-sparing agents had failed or were contraindicated. He developed no adverse effects from intravenous immunoglobulin, which allowed reduction of his prednisone to 3 mg/day, and his ulcer has completely healed.     

多发性骨髓瘤并发坏疽性脓皮病

报告1例多发性骨髓瘤并发坏疽性脓皮病.患者女,58岁.4个月前左下肢出现丘疹、斑块及溃疡,伴有疼痛和瘙痒.皮损组织病理检查示白细胞碎裂性血管炎.血清中检查出单克隆IgA λ链免疫球蛋白区带.骨髓穿刺检查示浆细胞及幼稚浆细胞增多.诊断:多发性骨髓瘤并发坏疽性脓皮病.     

Penile pyoderma gangrenosum successfully treated with topical Imiquimod

Pyoderma gangrenosum(PG) is a rare ulcerating inflammatory neutrophilic dermatosis. Genital involvement has been rarely reported. We report such a case of 24- year- old, male patient living with HIV/AIDS(PLHIV) who presented with progressive genital ulceration, not responding to oral antibiotics and aciclovir, gradually increasing in size over 15-18 months. Repeated biopsies showed acute on chronic inflammation. The lesion partially responded to oral and topical corticosteroids but soon increased in size after tapering the dosage of the steroids.Then patient was given Imiquimod 5% cream to be applied over the lesion once daily for 2-4 weeks. Lesion cleared completely in 4 weeks and is in remission since last 6 months. The case report highlights the successful use of topical Imiquimod 5% cream in the treatment of penile PG.     

Sarcoidosis and pyoderma gangrenosum: an exceptional association. The role of trauma and immunosuppressive agents

The coexistence of sarcoidosis and pyoderma gangrenosum has rarely been reported. We have found only three cases in our review of the literature. Herein, we report a new case and discuss the role of trauma and immunosuppression in the development of PG, and the efficacy of cyclosporin A in PG and sarcoidosis.     

坏疽性脓皮病累及多脏器1例

报告１例坏疽性脓皮病，皮损为多发脓疱，结节，溃疡，分布于双下肝为主，疼痛剧烈，组织病理示真皮中有众多嗜中性白细胞浸润，这一例坏疽脓皮病累及多脏器，造成气管损伤及肺浸润，胸腔积液，采用皮质类固醇激素及免疫抑制剂治疗获得满意疗效。     

Acquired ichthyosis and pyoderma gangrenosum in a patient with systemic lupus erythematosus

A 25-year-old woman who was 20 weeks pregnant developed systemic lupus erythematosus with acquired ichthyosis and pyoderma gangrenosum. The course of these dermatoses suggests that an immunopathological mechanism was implicated in their pathogenesis.     

A case of vulvar pyoderma gangrenosum associated with collagenous colitis

Pyoderma gangrenosum is a reactive inflammatory dermatosis which belongs to the spectrum of neutrophilic dermatoses. Due to a lack of diagnostic criteria, pyoderma gangrenosum is mainly a diagnosis of exclusion. It is rarely observed on the perineum, and vulvar involvement is even less frequent. Collagenous colitis is an idiopathic inflammatory colonic disease that is included in the microscopic colitides. The colonic mucosa and the crypt architecture are preserved but histologic alterations are found. We describe a case of collagenous colitis associated with vulvar pyoderma gangrenosum that improved spectacularly with cyclosporine 3 mg/kg/day and the twice-daily application of topical tacrolimus 0.1%.     

Refractory pyoderma gangrenosum treated with infliximab in an infant

We report the case of an 11‐month‐old boy with severe recalcitrant pyoderma gangrenosum refractory to prednisone, dapsone and ciclosporin. Treatment with infliximab was well tolerated, and resulted in an excellent clinical response that has been sustained for 15 months. The characteristics of this condition in children and the use of infliximab in infants are both reviewed.