scholarly journals Pyoderma gangrenosum and ulcerative colitis in the tropics

2008 ◽  
Vol 41 (6) ◽  
pp. 664-667 ◽  
Author(s):  
Olatunji B. Alese ◽  
David O. Irabor
Keyword(s):  
Rheumatoid Arthritis ◽  
Ulcerative Colitis ◽  
Pyoderma Gangrenosum ◽  
Myeloproliferative Disorders ◽  
Skin Lesions ◽  
Skin Condition ◽  
Wound Dressings ◽  
Systemic Disorder ◽  
Inflammatory Bowel ◽  
The Tropics

Pyoderma gangrenosum is a rare inflammatory skin condition, characterized by progressive and recurrent skin ulceration. There may be rapidly enlarging, painful ulcers with undermined edges and a necrotic, hemorrhagic base. Disorders classically associated with pyoderma gangrenosum include rheumatoid arthritis, inflammatory bowel disease, paraproteinemia and myeloproliferative disorders. There have been some reports of the occurrence of pyoderma gangrenosum in Africa, and in Nigeria, but only one specifically reported pyoderma gangrenosum in association with ulcerative colitis. We report on a 45-year-old man who presented with pyoderma gangrenosum associated with ulcerative colitis; the second report in Nigeria. The skin lesions were managed with daily honey wound dressings. Oral dapsone and prednisolone were started. The frequency of the bloody diarrhea decreased, and was completely resolved by the second week after admission. The ulcers also showed accelerated healing. The goal of therapy is directed towards the associated systemic disorder, if present.

Chemotherapy-induced pyoderma gangrenosum

WCET Journal ◽  
2019 ◽  
pp. 9-17
Author(s):  
Michelle Wai Kuen Lee ◽  
Steven Kar Kay Chan
Keyword(s):  
Pyoderma Gangrenosum ◽  
Systemic Disease ◽  
Skin Lesions ◽  
Skin Condition ◽  
The Other ◽  
Acute Trauma ◽  
Inflammatory Bowel ◽  
Haematological Disorders ◽  
Chronic Myelomonocytic Leukaemia ◽  
Rheumatoid Diseases

Pyoderma gangrenosum (PG) is a refractory, painful, non-infectious, ulcerative and inflammatory skin condition. Approximately 50% of patients with PG showed an existing systemic disease, such as inflammatory bowel conditions, haematological disorders, rheumatoid diseases or hepatopathies. Some patients developed PG following acute trauma or injury in a process known as pathergy. In the other cases, PG is characterised by isolated skin lesions with unknown causes and classified as idiopathic. However, in recent decades, PG has been reported in patients treated with certain medications. In this manuscript, we report two cases of PG, which were triggered by chemotherapy in patients with myelodysplastic syndrome (MDS) and chronic myelomonocytic leukaemia (CMML).

Mucocutaneous Manifestations of Inflammatory Bowel Disease in Turkey

2014 ◽  
Vol 18 (6) ◽  
pp. 397-404 ◽  
Author(s):  
Filiz Topaloǧlu Demir ◽  
Emek Kocatürk ◽  
Elif Yorulmaz ◽  
Gupse Adali ◽  
Mukaddes Kavala
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
Skin Lesions ◽  
Skin Condition ◽  
Whole Body ◽  
Bowel Diseases ◽  
Duration Of Disease ◽  
Inflammatory Bowel ◽  
And Gender

Background: Mucocutaneous manifestations of inflammatory bowel diseases are relatively common; the mean incidence is around 10% at the time of diagnosis. However, during follow-up, an increased variety of skin lesions, granulomatous cutaneous disease, reactive skin eruptions, nutritional defiencies, and other associated conditions may develop. Objective: The objective of this study was to evaluate the prevalence of the mucocutaneous manifestations and their association with gender, duration of disease, arthritis, location of the bowel disease, and disease activity. Methods: Fifty-six patients with ulcerative colitis (UC) and 36 patients with Crohn disease (CD) who were in follow-up in the Istanbul Medeniyet University Göztepe Training and Research Hospital Department of Gastroenterology were included in the study. Whole-body dermatologic examinations were performed for all patients, and patient files were evaluated for mucocutaneous manifestations. Results: Of the 92 patients, 49 (53.26%) presented with at least one mucocutaneous manifestation (58.9% of patients with UC and 44.4% of patients with CD). Of these, 38 (41.3%) had at least one reactive skin eruption. Aphthous stomatitis was noted in 33 patients (35.86%) and became the most common mucocutaneous manifestation. Granulomatous cutaneous diseases were detected in 18 patients (19.57%), and none of the patients had a nutritional deficiency–associated skin condition. Only 3 patients (3.26%) had erythema nodosum and 2 patients (2.17%) had pyoderma gangrenosum. Conclusions: We found that mucocutaneous manifestations of inflammatory bowel diseases are more common than thought and are more common in UC than in CD. No association was detected between mucocutaneous manifestions and gender, duration of disease, arthritis, location of the bowel disease, and activity of the disease.

scholarly journals Pyoderma Gangrenosum of the Chest Wall in a Male Patient with Ulcerative Colitis

2021 ◽  
Vol 96 (1) ◽  
pp. 59-63
Author(s):  
Man Ki Choi ◽  
Yeong Joo Jeong ◽  
Seung Goun Hong
Keyword(s):  
Ulcerative Colitis ◽  
Chest Wall ◽  
Pyoderma Gangrenosum ◽  
Male Patient ◽  
Breast Surgery ◽  
Left Breast ◽  
Upper Extremities ◽  
The Face ◽  
History Of ◽  
Inflammatory Bowel

Ulcerative colitis, an inflammatory bowel disease, often exhibits extra-intestinal manifestations including various dermatological problems. Pyoderma gangrenosum (PG) is a painful ulcerative cutaneous disorder characterized by the development of rapidly enlarging nodules. The lesion may become aggravated when ulcerative colitis is active, and it commonly affects the extensor surfaces of the lower extremities but rarely the upper extremities, face, periauricular area, anterior chest, back, or buttocks. We encountered a rare case of PG of the chest wall near the left breast, on the face and pretibial area of a male patient with ulcerative colitis. He had not undergone breast surgery and had no history of trauma. The lesion and symptoms were successfully treated by steroid and mesalazine; there was no need for surgery or more potent drugs.

scholarly journals Folgoration as an Example of Pathergy in a Patient Affected by Pyoderma Gangrenosum and Takayasu's Arteritis

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
A. G. Richetta ◽  
S. D'Epiro ◽  
C. Mattozzi ◽  
S. Giancristoforo ◽  
S. Calvieri
Keyword(s):  
Rheumatoid Arthritis ◽  
Ulcerative Colitis ◽  
Pyoderma Gangrenosum ◽  
Monoclonal Gammopathy ◽  
Takayasu’S Arteritis ◽  
Clinical Manifestations ◽  
Neutrophilic Dermatosis ◽  
Minor Trauma ◽  
Takayasu's Arteritis ◽  
Unknown Aetiology

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis of unknown aetiology. Clinical manifestations of PG are characterized by destructive, necrotizing, and noninfective ulceration of the skin. 20–30% of cases are initiated and aggravated by minor trauma or surgery, a phenomenon named pathergy. PG is related to several autoimmune diseases including ulcerative colitis, Crohn's disease, rheumatoid arthritis, and monoclonal gammopathy. The association with Takayasu's arteritis (TA), a chronic inflammatory and stenotic disease of large and medium-sized arteries, is instead less common. We report a case of PG associated with TA that was induced by an accident with folgoration of the skin; in this case the folgoration can be considered as an exemple of Pathergy, that is, a characteristic feature of PG.

scholarly journals Nasal Septal Perforation Associated with Pyoderma Gangrenosum

2015 ◽  
Vol 6 (2) ◽  
pp. ar.2015.6.0118 ◽  
Author(s):  
Brook McConnell ◽  
M. Sherif Said ◽  
Vijay R. Ramakrishnan
Keyword(s):  
Inflammatory Bowel Disease ◽  
Case Report ◽  
Pyoderma Gangrenosum ◽  
Bowel Disease ◽  
Skin Condition ◽  
Septal Perforation ◽  
Nasal Septal Perforation ◽  
Inflammatory Bowel ◽  
Complete History ◽  
Rule Out

Background Pyoderma gangrenosum (PG) is a skin condition characterized by necrotic ulcers and most commonly occurs on the legs in association with inflammatory bowel disease and rheumatoid arthritis; however, PG rarely involves the head and neck, and very rarely causes nasal septal perforation. Objective Here, we describe a case report of PG causing nasal septal perforation in a 71-year-old male with truncal lesions in the absence of either inflammatory bowel disease or autoimmune arthritis. Methods Case report with histologic description. Results Histology from nasal mucosal biopsies showed chronic inflammation and reactive change without evidence of malignancy. Together with serologic and nonserologic testing, as well as clinical evaluation, we were able to rule out other causes of septal perforation including Wegener's granulomatosis, lymphoma, and vasculitis, and concluded that the cause of nasal septal perforation was most likely PG. Conclusion Septal perforation etiology should include a complete history and physical to evaluate for systemic etiologies, including rare ones such as PG.

scholarly journals Sarcopenia in Inflammatory Bowel Disease: A Narrative Overview

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 656
Author(s):  
Amritpal Dhaliwal ◽  
Jonathan I. Quinlan ◽  
Kellie Overthrow ◽  
Carolyn Greig ◽  
Janet M. Lord ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Common Condition ◽  
Surgical Interventions ◽  
Inflammatory Bowel ◽  
The Impact

Malnutrition is a common condition encountered in patients with inflammatory bowel disease (IBD) and is often associated with sarcopenia (the reduction of muscle mass and strength) which is an ever-growing consideration in chronic diseases. Recent data suggest the prevalence of sarcopenia is 52% and 37% in Crohn’s disease and ulcerative colitis, respectively, however it is challenging to fully appreciate the prevalence of sarcopenia in IBD. Sarcopenia is an important consideration in the management of IBD, including the impact on quality of life, prognostication, and treatment such as surgical interventions, biologics and immunomodulators. There is evolving research in many chronic inflammatory states, such as chronic liver disease and rheumatoid arthritis, whereby interventions have begun to be developed to counteract sarcopenia. The purpose of this review is to evaluate the current literature regarding the impact of sarcopenia in the management of IBD, from mechanistic drivers through to assessment and management.

scholarly journals Levels of Anti-Citrullinated Protein Antibodies and Rheumatoid Factor, Including IgA Isotypes, and Articular Manifestations in Ulcerative Colitis and Crohn’s Disease

2020 ◽  
Vol 17 (21) ◽  
pp. 8054
Author(s):  
Koen M. J. Janssen ◽  
Hilde Hop ◽  
Arjan Vissink ◽  
Gerard Dijkstra ◽  
Menke J. de Smit ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Rheumatoid Factor ◽  
Healthy Subjects ◽  
Immunoglobulin A ◽  
Mucosal Inflammation ◽  
Inflammatory Bowel ◽  
Citrullinated Protein

Systemic presence of arthritis autoantibodies (AAb) is specific for rheumatoid arthritis (RA). AAb initiation might be triggered by chronic mucosal inflammation, such as in inflammatory bowel disease (IBD). We assessed the prevalence of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF) in ulcerative colitis (UC) and Crohn’s disease (CD) patients, with regard to the prevalence of joint complaints in AAb+ versus AAb− IBD patients. RA patients and healthy subjects (HC) served as controls. Serum was collected from 226 UC, 165 CD and 86 RA patients, and 36 HCs. One-hundred-and-ten UC (48.7%) and 76 CD (46.1%) patients were seropositive for at least one autoantibody, compared to 4 (13.9%) HCs and 81 (94.2%) RA patients. Eighty-three (37%) UC and 52 (32%) CD patients were seropositive for the anti-cyclic citrullinated protein antibody (anti-CCP2) of the immunoglobulin A type (IgA anti-CCP2), compared to 1 (2.8%) HC and 64 (74%) RA patients. RF of the immunoglobulin G type (IgG RF) and IgA RF seropositivity in UC and CD patients was comparable to HCs and low compared to RA patients. Arthralgia was reported by 34 (18.7%) UC and 50 (33.1%) CD patients, but presence of arthralgia was not increased in AAb+ patients. AAbs are frequently present in IBD patients, supporting the hypothesis that inflammation of intestinal mucosa induces low systemic levels of ACPA.

scholarly journals Anti-TNF-Related Leukocytoclastic Vasculitis in Ulcerative Colitis: A Case Report

2021 ◽  
Vol 18 (13) ◽  
pp. 6711
Author(s):  
Valentina Giorgio ◽  
Elisa Blasi ◽  
Donato Rigante ◽  
Cristina Guerriero ◽  
Clara De Simone ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Leukocytoclastic Vasculitis ◽  
Skin Lesions ◽  
Skin Reactions ◽  
Case Presentation ◽  
Steroid Dependent ◽  
Tnf Α ◽  
Bowel Diseases ◽  
Dependent Form ◽  
Inflammatory Bowel

Background: The development of drugs directed against tumor necrosis factor (TNF)-α has dramatically modified the therapeutic approach to inflammatory bowel diseases: a larger use of such drugs has also led to a major knowledge about their adverse effects, especially on skin. The aim of this report was to describe a rare steroid-dependent form of leukocytoclastic vasculitis induced by an anti-TNF-α agent in a young woman with ulcerative colitis. Case presentation: A young girl with ulcerative colitis developed a form of leukocytoclastic vasculitis induced by an anti-TNF-α agent. Recurrent palpable purpuric lesions on her legs were the main cutaneous manifestation. Skin lesions were steroid-dependent, but improved after withdrawal of the anti-TNF-α agent and second-line immunosuppressant therapy. Conclusions: The need to develop specific recommendations to guide the use of medications for managing skin reactions induced by anti-TNF-α drugs is herein emphasized.

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 Dermatitis Artefacta Resembling Pyoderma Gangrenosum

2020 ◽  
Vol 4 (2) ◽  
pp. 156
Author(s):  
Mary Michael ◽  
Andrew Newman ◽  
Jason Barr ◽  
Travis Lam
Keyword(s):  
Patient Outcomes ◽  
Pyoderma Gangrenosum ◽  
Skin Lesions ◽  
Skin Condition ◽  
Psychosocial Stressors ◽  
Dermatitis Artefacta ◽  
Psychological Conditions ◽  
Good Patient ◽  
Self Harm ◽  
Variable Morphology

Dermatitis artefacta is a self-inflicted skin condition that clinically mimics other dermatologic conditions. The etiology is multifactorial and is linked to underlying psychological conditions or psychosocial stressors with relief from automutilation. Lesions present with variable morphology depending on the type of self-harm and therefore, is a diagnosis of exclusion. We present a case of lesions that initially appeared to be pyoderma gangrenosum due to a similar presentation of nonspecific ulcers on the lower extremity. An important clue to the diagnose of dermatitis artefacta are skin lesions that do not fit a particular histopathological category. Lesions will also be resistant to conventional treatment. Once other dermatologic conditions are ruled out, it is important to consider dermatitis artefacta since early intervention is necessary for good patient outcomes.

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