Synchronous pyoderma gangrenosum and inflammatory bowel disease, healing after total proctocolectomy

We present a female patient observed with painful violaceous plaques with central bullae and pustules on the lower limbs, rapidly transformed into ulcers, associated with bloody diarrhea, recurrent oral erosions and hyperthermia in the previous 3 months. Cutaneous biopsy was consistent with pyoderma gangrenosum, and intestinal diagnostic procedures revealed a non-classifiable inflammatory bowel disease with high x-ANCA titers. Soon after admission the patient was submitted to total proctocolectomy following colonic perforation. Complete ulcer healing occurred three months after surgery, without recurrence. Pyoderma gangrenosum is a rare dermatosis frequently associated with inflammatory bowel disease. This case is particularly interesting for the synchronic clinical presentation of cutaneous and intestinal diseases, but also for the prompt regression of the former after total proctocolectomy.

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Pyoderma Gangrenosum in the Urologist Clinic

Current Urology ◽

10.1159/000447133 ◽

2015 ◽

Vol 9 (3) ◽

pp. 159-162 ◽

Cited By ~ 1

Author(s):

Dina J. Ludwig ◽

Hossain Roshani ◽

Martijn G. Steffens ◽

Frederik C. Moll ◽

Robertus G. Teepe

Keyword(s):

Inflammatory Bowel Disease ◽

T Cell ◽

Pyoderma Gangrenosum ◽

Bowel Disease ◽

Skin Disorder ◽

Clinical Presentation ◽

Hematological Malignancy ◽

Systemic Diseases ◽

Rheumatological Disease ◽

Inflammatory Bowel

Pyoderma gangrenosum is a rare non-infectious skin disorder. It is often associated with systemic diseases, like the inflammatory bowel disease, rheumatological disease and (hematological) malignancy. The diagnosis is affirmed through a process of elimination and is principally based on clinical presentation and course. We present a 59-year-old male with T-cell large granular lymphocyte leukemia and pyoderma gangrenosum of penis and scrotum. Finally the patient was successfully treated with systemic prednisolone.

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A156 SERUM TUMOUR NECROSIS FACTOR-α ANTAGONIST DRUG CONCENTRATIONS IN PATIENTS WITH PYODERMA GANGRENOSUM ASSOSCIATED WITH INFLAMMATORY BOWEL DISEASE

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.154 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 162-163

Author(s):

M Mikail ◽

A Wilson

Keyword(s):

Inflammatory Bowel Disease ◽

Pyoderma Gangrenosum ◽

Bowel Disease ◽

Complete Resolution ◽

Therapeutic Drug ◽

Drug Concentrations ◽

Median Serum ◽

Inflammatory Bowel ◽

Factor Α ◽

Necrosis Factor

Abstract Background The utility of therapeutic drug monitoring for guiding the dosing of tumor necrosis factor-α antagonists (TNFAs) in luminal inflammatory bowel disease (IBD) is well-established and well-accepted. TNFAs, specifically infliximab and adalimumab, have become integral to the management of the rare, neutrophilic dermatosis, pyoderma gangrenosum (PG) in IBD. Little is known regarding the target serum TNFA concentrations to guide dosing to achieve resolution of PG in IBD. Aims To describe the serum TNFA concentrations (infliximab or adalimumab) associated with the resolution of PG lesions in patients with IBD. Methods Patients with IBD and associated PG treated with one of infliximab or adalimumab (collectively known as TNFAs) seen at two academic hospitals affiliated with Western University were identified. Serum TNFA concentrations were assessed at the time of PG treatment. Results Nine patients were identified. All patients had IBD-associated PG. Seven patients were treated with infliximab and 2 patients were treated with adalimumab. All patients received standard dosing. Eight patients had complete resolution of their PG, while one had near complete resolution at the time of last follow-up. A median serum infliximab concentration of 3.00 (IQR, 3.52) µg/ml at week 14 and a median serum adalimumab concentration of 2.02 (IQR, 0.98) µg/ml at week 12 were seen at the time of PG treatment. Conclusions Herein, we report low serum TNFA concentrations despite PG healing in a cohort of IBD patients. This is lower than what is in patients for successful TNFA treatment in luminal and fistulising IBD. Funding Agencies NoneNone.

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Su1984 CLINICAL PRESENTATION AND OUTCOMES OF PRIMARY SCLEROSING CHOLANGITIS AND AUTOIMMUNE HEPATITIS IN INFLAMMATORY BOWEL DISEASE

Gastroenterology ◽

10.1016/s0016-5085(20)32510-5 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-732-S-733

Author(s):

Camilla A. Martins ◽

Ana Elisa R. Caon ◽

Marilia G. Cruz ◽

Luísa L. Barros ◽

Alexandre Carlos ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Autoimmune Hepatitis ◽

Primary Sclerosing Cholangitis ◽

Bowel Disease ◽

Sclerosing Cholangitis ◽

Clinical Presentation ◽

Inflammatory Bowel

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Intravenous Cyclosporine in Refractory Pyoderma Gangrenosum Complicating Inflammatory Bowel Disease

Inflammatory Bowel Diseases ◽

10.1097/00054725-200102000-00001 ◽

2001 ◽

Vol 7 (1) ◽

pp. 1-7 ◽

Cited By ~ 47

Author(s):

Sonia Friedman ◽

James F. Marion ◽

Ellen Scherl ◽

Peter H. Rubin ◽

Daniel H. Present

Keyword(s):

Inflammatory Bowel Disease ◽

Pyoderma Gangrenosum ◽

Bowel Disease ◽

Inflammatory Bowel

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Very early onset inflammatory bowel disease (VEO-IBD); spectrum of clinical presentation, diagnostic tools and outcome in children

Journal of the Pakistan Medical Association ◽

10.47391/jpma.05-725 ◽

2021 ◽

Vol 71 (10) ◽

pp. 2350-2354

Author(s):

Huma Arshad Cheema ◽

Nadia Waheed ◽

Anjum Saeed ◽

Zafar Fayyaz ◽

Muhammad Nadeem Anjum ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Early Onset ◽

Clinical Presentation ◽

Association Studies ◽

Diagnostic Tools ◽

Genome Wide Association Studies ◽

Genome Wide ◽

Basic Work ◽

Inflammatory Bowel

Background: Very early-onset inflammatory bowel disease (VEO-IBD) is defined as diagnosis of Ulcerative Colitis (UC) or Crohn’s Disease (CD) in children under six years of age. Genome wide association studies have linked a strong genetic component responsible for VEO-IBD. Approximately, 30-40% children of VEO-IBD have underlying immunodeficiency states. We aimed to study the spectrum of presentation, underlying monogenetic defects and outcome in VEO-IBD. Methods: This is a prospective, observational study conducted at division of Gastroenterology, the Children's Hospital & the Institute of Child Health, Lahore, over 2 years. Children developing features of IBD under six-years of age were included. Data included demography, clinical presentation, diagnostic tools and outcome. Gastroscopy and colonoscopy were performed in all patients in addition to basic work up done for associatedimmunodeficiency states and molecular genetics. SPSS version 21 was used for analysis. Continuous...

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Pyoderma Gangrenosum in a Patient with Essential Thrombocythemia

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347540000400213 ◽

2000 ◽

Vol 4 (2) ◽

pp. 107-109 ◽

Cited By ~ 5

Author(s):

Kim W. King ◽

Alexander Murray

Keyword(s):

Inflammatory Bowel Disease ◽

Pyoderma Gangrenosum ◽

Essential Thrombocythemia ◽

Bowel Disease ◽

Hematologic Disease ◽

Inflammatory Bowel

Background: Pyoderma gangrenosum is an uncommon ulcerative condition associated with inflammatory bowel disease, arthritis, and hematologic disease. We report a patient with essential thrombocythemia and pyoderma gangrenosum. Objective: This article is a review of the associations between pyoderma gangrenosum and other diseases. Results: There have been two previous reports of patients with pyoderma gangrenosum and essential thrombocythemia. Conclusion: There may be a possible association between pyoderma gangrenosum and essential thrombocythemia. The diagnosis of pyoderma gangrenosum should be considered in patients with essential thrombocythemia and cutaneous ulcers.

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Types of colorectal cancer and dysplasia associated with inflammatory bowel disease

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20220052 ◽

2022 ◽

Author(s):

Hisham Abdullah Almottowa ◽

Abdulmohsen Yaseer Alkhars ◽

Maram Hussam Hassan ◽

Hamad Adel Alhamad ◽

Saad Munawwikh Alshammari ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Diagnostic Procedures ◽

Intestinal Wall ◽

Management Algorithm ◽

Online Databases ◽

Major Development ◽

Histological Characteristics ◽

Inflammatory Bowel ◽

Based Medicine

Ulcerative colitis (UC) and Crohn’s disease (CD) are two major inflammatory disorders of the intestinal wall collectively known as inflammatory bowel disease (IBD). Colorectal carcinoma (CRC) is the most significant and grave consequence of IBD and is preceded by dysplasia in majority of the cases. In this review we aim to discuss the various types of dysplasia found in patients with CRC due to IBD. A thorough literature search was conducted in online databases such as PubMed, Google Scholar, from which all studies published in the last ten years were included in this review. The major development in diagnostic procedures and visualization modalities have aided our understanding of dysplasia, which is now known to be the strongest predictor and marker for CRC development. However, the unpredictable behavior and progression of dysplasia still warrants vigilant surveillance. Dysplasia has been classified on histological characteristics using grades of dysplasia from ‘negative for dysplasia’ to ‘high grade dysplasia’. On visibility via an endoscope from ‘visible dysplasia’ to ‘invisible dysplasia’ and macroscopic features of ‘conventional dysplasia’ and ‘non-conventional dysplasia’. No single classification can be utilized to define the stage of dysplasia and more importantly predict its progression and outcome of CRC. Using evidence-based medicine an integrated classification expanding on a management algorithm must be formulated by a panel of experts to steer management of the disease. A multidisciplinary, tailored approach with a strong emphasis on regular and timely surveillance to ensure early detection of CRC can enhance quality of life and patient outcomes.

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