scholarly journals Pyoderma gangrenosum with renal and splenic impairment - case report

2013 ◽  
Vol 88 (6 suppl 1) ◽  
pp. 150-153 ◽  
Author(s):  
Luciana Rabelo de Carvalho ◽  
Virgínia Vinha Zanuncio ◽  
Bernardo Gontijo
Keyword(s):  
Case Report ◽  
Renal Impairment ◽  
Pyoderma Gangrenosum ◽  
Lower Limbs ◽  
Neutrophilic Dermatosis ◽  
Internal Organs ◽  
Cutaneous Manifestations ◽  
Neutrophilic Infiltrate ◽  
Multisystemic Disease

Pyoderma gangrenosum is an uncommon and recurrent neutrophilic dermatosis of unknown cause. The lesions usually start as tender sterile papulopustules or erythematous nodules that undergo necrosis followed by ulceration. The lower limbs are most commonly affected and around half of the cases are associated with systemic disorders. Although rare, cases of pyoderma gangrenosum with extramucocutaneous sterile neutrophilic infiltrate have been reported, with the lungs being the most commonly affected organ. We report a case of pyoderma gangrenosum with splenic and renal impairment. Pyoderma gangrenosum should be considered a multisystemic disease with classic cutaneous manifestations and potential involvement of internal organs.

scholarly journals UNILATERAL PYODERMA GANGRENOSUM OF THE EXTERNAL EAR IN A RESOURCE LIMITED SETTING: CASE REPORT AND LITERATURE REVIEW

2020 ◽  
Author(s):  
Zephania Abraham ◽  
Edwin Thomas ◽  
Aveline Kahinga
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Pyoderma Gangrenosum ◽  
Resource Limited Setting ◽  
Neutrophilic Dermatosis ◽  
External Ear ◽  
Prompt Treatment ◽  
Resource Limited ◽  
High Index Of Suspicion ◽  
Limited Setting

Pyoderma gangrenosum (PG) being a primary sterile neutrophilic dermatosis, the etiology is still uncertain and it rarely affects children. A high index of suspicion is essential to execute its prompt treatment. To the best of our knowledge this is the first reported case in our country

scholarly journals Pyoderma Gangrenosum: A Rare Cause of Cutaneous Ulceration and One Easily Misdiagnosed

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Wedad Abdelrahman ◽  
Maureen Y. Walsh ◽  
Susannah E. Hoey ◽  
Donal O’Kane
Keyword(s):  
Skin Biopsy ◽  
Pyoderma Gangrenosum ◽  
Clobetasol Propionate ◽  
Neutrophilic Dermatosis ◽  
Dramatic Improvement ◽  
Left Shift ◽  
Neutrophilic Infiltrate ◽  
Deep Ulceration ◽  
One Year ◽  
In Infants And Children

Pyoderma gangrenosum (PG) is a rare inflammatory neutrophilic dermatosis often misdiagnosed. It is uncommon in infants and children accounting for 4% of cases. A one-year-old male in paediatric ICU ventilated for bronchopneumonia was referred with ulcerated areas on his neck and axilla corresponding to sites of recent removal of central and arterial lines. Examination revealed areas of deep ulceration with violaceous undermined borders in keeping with PG. This was supported by a skin biopsy showing a neutrophilic infiltrate in the deeper dermis. Topical clobetasol propionate was commenced and a dramatic improvement within 24 hours noted. Blood results showed a leucocytosis of 29.7; a differential WCC showed toxic granulation in neutrophils with myeloid left shift; immunoglobulins showed elevated IgG 23 and IgA 4.86. The elevated WCC made us consider a leukaemic trigger; however, they settled with treatment of the underlying infection. PG in children is more likely to have an atypical distribution involving the head and neck (26.6%) or buttocks (15%). An interesting feature in this case is the presence of pathergy, a term used to describe the induction or exacerbation of PG at sites of iatrogenic or incidental trauma. It is seen in 31% of patients with PG.

CASE REPORT-Delayed Cutaneous Manifestations of Graves’ disease, ADecade Post-Total Thyroidectomy

2020 ◽  
Vol 3 (2) ◽  
pp. 1-4
Keyword(s):  
Case Report ◽  
Total Thyroidectomy ◽  
Lower Limbs ◽  
Graves Disease ◽  
Cutaneous Manifestations ◽  
Digital Clubbing ◽  
Pretibial Myxoedema

Pretibial myxoedema and thyroid acropachy are rare manifestations of Graves’ disease. Clinically, pretibial myxoedema is characterised by hyper-pigmented,asymmetrical, indurated non-pitting lesions of the lower limbs, whilst thyroidacropachy presents as digital clubbing and swelling of digits and toes. We describe a59-year-old female, who presents with pretibial myxoedema and thyroid acropachy,a decade post-thyroidectomy for Graves’ disease.

scholarly journals Pyoderma Gangrenosum following Pacemaker Implantation: A Case Report and Review of Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Noura Ayoubi ◽  
Zaydi Javeed ◽  
Raymond Cutro ◽  
Brooke T. Baldwin
Keyword(s):  
Case Report ◽  
Pyoderma Gangrenosum ◽  
Pacemaker Implantation ◽  
Contralateral Side ◽  
Neutrophilic Dermatosis ◽  
Minor Trauma ◽  
Review Of Literature ◽  
Systemic Corticosteroids ◽  
History Of ◽  
Symptomatic Bradycardia

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by noninfectious, inflammatory, ulcerating lesions. Pathergy can be seen in these patients, whereby minor trauma or surgery can result in the development of PG ulcerations. Here, we present a case of PG following pacemaker implantation. A 76-year-old male with a history of rheumatoid arthritis presented to the cardiology team with symptomatic bradycardia. Indications for implantation were met, and the procedure was performed in a routine fashion. The patient returned to clinic for follow-up four days later, complaining of pain at the incision site, coupled with erythema and purulent drainage. Consultations with an infectious disease specialist and a dermatologist were requested, and the diagnosis of pyoderma gangrenosum was considered. The patient underwent device removal and received systemic corticosteroids at a dose of 1 mg/kg prednisone with complete lesion healing in 3 weeks. While being maintained on steroids, the patient underwent reimplantation of a new pacemaker on the contralateral side without complication and had a normal postoperative course. We present this case report, along with the review of literature, in order to highlight the multidisciplinary approach to management, which requires dermatologic treatment in order to achieve pacemaker success.

scholarly journals Pyoderma Gangrenosum Induced by BNT162b2 COVID-19 Vaccine in a Healthy Adult

Vaccines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 87
Author(s):  
Mazin Barry ◽  
Abdulaziz AlRajhi ◽  
Khaldoon Aljerian
Keyword(s):  
Pyoderma Gangrenosum ◽  
Messenger Rna ◽  
Skin Lesions ◽  
Neutrophilic Dermatosis ◽  
Unknown Etiology ◽  
Rapid Improvement ◽  
Inflammatory Infiltration ◽  
Cutaneous Manifestations ◽  
Wide Scale ◽  
Monitoring And Surveillance

(1) Background: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis of unknown etiology. Coronavirus disease 2019 (COVID-19) vaccines can cause a variety of adverse cutaneous manifestations. PG associated with mRNA vaccines has not previously been described. This case study reports on the first patient to develop PG after receiving BNT162b2. (2) Case Presentation: An otherwise-healthy 27-year-old man developed multiple skin lesions 24 h after receiving the first dose of the messenger RNA-based Pfizer/BioNTech BNT162b2 COVID-19 vaccine. When in hospital, he developed a new painful ulcerative lesion on his right hand. Skin ulcer edge biopsy showed severe epidermal neutrophilic infiltrate with epidermal and dermal edema, underlying superficial dermal necrosis, and characteristic undermining with extensive mixed inflammatory infiltration of the dermis and abscess formation consistent with an ulcer with mixed dermal inflammation compatible with pyoderma gangrenosum. The lesion showed rapid improvement after the initiation of immunosuppressive therapy. (3) Conclusions: PG may be a rare adverse event related to the BNT162b2 vaccine, which could be more frequently encountered with the wide-scale use of mRNA vaccines. The continuous monitoring and surveillance of skin manifestations post-vaccination is essential.

scholarly journals Pyoderma gangrenosum: A clinico- therapeutic profile of patients attending a tertiary care hospital in Nepal

2012 ◽  
Vol 8 (1) ◽  
pp. 29-35
Author(s):  
C Kharel ◽  
S Agrawal ◽  
A Rijal ◽  
S Bhattarai
Keyword(s):  
Ulcerative Colitis ◽  
Pyoderma Gangrenosum ◽  
Tertiary Care ◽  
Lower Limbs ◽  
Neutrophilic Dermatosis ◽  
Care Hospital ◽  
Medical Sciences ◽  
Inflammatory Bowel ◽  
Therapeutic Profile

Pyoderma gangrenosum (PG) is a primarily sterile inflammatory neutrophilic dermatosis characterized by recurrent cutaneous ulcerations with mucopurulent or hemorrhagic exudate. In many cases, PG is associated with inflammatory bowel disease, rheumatic disorder or neoplasia. The peak of incidence occurs between the ages of 20 to 50 years with women being more often affected than men. To study the clinical and therapeutic profile of patients with pyoderma gangrenosum. All patients diagnosed as pyoderma gangrenosum in the department of dermatology from July 14th 2003- July 12th 2008 were included in the study. Demographic profile, clinical features as well as relevant investigations, treatment and follow-up were noted. A total of 8 patients with pyoderma gangrenosum were diagnosed over a 5 year period. There were 3 males and 5 female patients whose ages ranged from 32 to 80 years. Lower limbs were the commonest site to be involved in 6 patients (75%). Recurrent episodes were noted in 4 patients (50%) and among them 3 patients (75%) had multiple ulcers. Histopathological confirmation of the diagnosis was done in 7 patients (87.5%). Association with ulcerative colitis was seen in 2 patients (25%). All patients were treated with dapsone and systemic steroids which showed resolution of the lesions in all patients. Pyoderma gangrenosum was seen more frequently in females and association with ulcerative colitis was seen in 25% of the patients. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 29-35 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6823

scholarly journals Infliximab treatment for large, multifocal, abdominal pyoderma gangrenosum associated with ulcerative colitis: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2096411
Author(s):  
Maria Mikail ◽  
Aze Wilson
Keyword(s):  
Ulcerative Colitis ◽  
Case Report ◽  
Pyoderma Gangrenosum ◽  
Subtotal Colectomy ◽  
Systemic Disease ◽  
Neutrophilic Dermatosis ◽  
High Dose ◽  
Infliximab Treatment ◽  
The Impact

Pyoderma gangrenosum is an uncommon neutrophilic dermatosis that is highly associated with pathergy in the setting of trauma or surgery, systemic disease, or may be idiopathic. Herein, we present the case of a 68-year-old female with ulcerative colitis who underwent a subtotal colectomy with an end-ileostomy and presented post-operatively with large, multifocal pyoderma gangrenosum at two abdominal sites. She was managed with intralesional triamcinolone injections and high-dose systemic steroids and was transitioned to IV infliximab. Our case report illustrates the role of infliximab in the treatment of complicated multifocal pyoderma gangrenosum and contemplates the impact of systemic infliximab exposure.

Trends in the Association between Pyoderma Gangrenosum and Autoimmune Hepatitis: Case Report and Review of the Literature

2014 ◽  
Vol 18 (5) ◽  
pp. 345-352 ◽  
Author(s):  
Heidi Wat ◽  
Richard M. Haber
Keyword(s):  
Risk Factor ◽  
Case Report ◽  
Autoimmune Hepatitis ◽  
Pyoderma Gangrenosum ◽  
Subsequent Development ◽  
Neutrophilic Dermatosis ◽  
Review Of The Literature ◽  
Young Females ◽  
History Of ◽  
Hepatitis Case

Background: Pyoderma gangrenosum (PG) is a neutrophilic dermatosis commonly associated with underlying systemic illness, typically of autoimmune origin. The association of PG with autoimmune hepatitis (AIH) has been reported but remains poorly recognized. Observations: We describe a case of PG manifesting 5 years following the diagnosis of AIH and conduct a literature review to determine the significance of this association. We identified a predisposition for young females and a tendency for PG to arise 4 to 12 years after the diagnosis of AIH during a period of disease quiescence. Additionally, fulminant hepatitis as the initial presentation of AIH appears to be a risk factor in the subsequent development of PG. Conclusions: These observations may provide important clues for the pathogenesis of PG in the context of AIH. Recognition of this association has important implications for dermatologists in the evaluation, workup, and management of patients with a history of AIH and suspected PG.

scholarly journals Genital pyoderma gangrenosum revealing Behçet’s disease: a case report

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Hassina Chicha ◽  
Said Taharboucht ◽  
Nacera Tiboune ◽  
Nadia Touati ◽  
Ahcene Chibane
Keyword(s):  
Behçet’S Disease ◽  
Pyoderma Gangrenosum ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Underlying Disease ◽  
Lower Limbs ◽  
Neutrophilic Dermatosis ◽  
Behcet's Disease ◽  
Diagnostic Difficulties ◽  
Original Observation

Abstract Background Pyoderma gangrenosum (PG) is a rare and chronic neutrophilic dermatosis. It is clinically characterized by aseptic ulcerations preferentially located in the lower limbs. Its location in the genital area is unusual and could be a source of diagnostic difficulties. In half of the cases, PG is associated with an underlying disease. The association with Behçet’s disease is exceptional. Case presentation We report an original observation of a patient who presented a vulvar PG which revealed a Behçet’s disease. Conclusion The distinction between these two pathologies was difficult because of the similarity of the cutaneous-mucous lesions on the one hand, and the absence of histological specificity of these two pathologies on the other hand.

Congenital Syphilis Simulating Bone Neoplasm in 2-Month Old Infant – Case Report

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Case Report ◽  
Congenital Syphilis ◽  
Eosinophilic Granuloma ◽  
Osteolytic Lesion ◽  
Lower Limbs ◽  
Upper Body ◽  
Elective Cesarean Section ◽  
Distal Fibula ◽  
X Ray

Introduction: Congenital Syphilis (CS) occurs through the transplacental transmission of Treponema pallidum in inadequately treated or non-treated pregnant women, and is capable of severe consequences such as miscarriage, preterm birth, congenital disease and/or neonatal death. CS has been showing an increasing incidence worldwide, with an increase of 208% from 2009 to 2015 in Brazil. Case report: 2-month old infant receives care in emergency service due to edema of right lower limb with pain in mobilization. X-ray with osteolytic lesion in distal fibula. Infant was sent to the Pediatrics Oncology clinic. Perinatal data: 7 prenatal appointments, negative serology at 10 and 30 weeks of gestation. End of pregnancy tests were not examined and tests for mother’s hospital admission were not requested. Mother undergone elective cesarean section at 38 weeks without complications. During the pediatric oncologist appointment, patient showed erythematous-squamous lesions in neck and other scar-like lesions in upper body. A new X-ray of lower limbs showed lesions in right fibula with periosteal reaction associated with aggressive osteolytic lesion compromising distal diaphysis, with cortical bone rupture and signs of pathological fracture, suggestive of eosinophilic granuloma. She was hospitalized for a lesion biopsy. Laboratory tests: hematocrit: 23.1 / hemoglobin 7.7 / leukocytes 10,130 (without left deviation) / platelets 638,000 / Negative Cytomegalovirus IgG and IgM and Toxoplasmosis IgG and IgM / VDRL 1:128. Congenital syphilis diagnosis with skin lesions, bone alterations and anemia. Lumbar puncture: glucose 55 / total proteins 26 / VDRL non reagent / 13 leukocytes (8% neutrophils; 84% monomorphonuclear; 8% macrophages) and 160 erythrocytes / negative VDRL and culture. X-ray of other long bones, ophthalmological evaluation and abdominal ultrasound without alterations. Patient was hospitalized for 14 days for treatment with Ceftriaxone 100mg/kg/day, due to the lack of Crystalline Penicillin in the hospital. She is now under outpatient follow-up. Discussion: CS is responsible for high rates of morbidity and mortality. The ongoing increase of cases of this pathology reflects a severe health issue and indicates failures in policies for the prevention of sexually transmitted diseases, with inadequate follow-up of prenatal and maternity protocols.

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