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Atypical Forms of Pyoderma Gangrenosum in Inflammatory Bowel Disease: Report of Four Cases and Literature Review.

التفاصيل البيبلوغرافية
العنوان: Atypical Forms of Pyoderma Gangrenosum in Inflammatory Bowel Disease: Report of Four Cases and Literature Review.
المؤلفون: Martinelli VF; Department of Gastroenterology, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil.; Department of Gastroenterology, Member of Organização Brasileira de Doença de Crohn e Retocolite - GEDIIB, São Paulo, Brazil., Martinelli Barbosa P; Department of Internal Medicine, Medical Sciences Center, Pernambucana of Health College, Recife, Pernambuco, Brazil., Dantas de Oliveira LS; Department of Gastroenterology, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil., de Melo LALV; Department of Gastroenterology, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil., Casa Nova JM; Department of Gastroenterology, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil., de Brito CAA; Department of Gastroenterology, Member of Organização Brasileira de Doença de Crohn e Retocolite - GEDIIB, São Paulo, Brazil.; Department of Internal Medicine, Center of Medical Sciences of Federal University of Pernambuco, Pernambuco, Brazil.; Department of Immunology, Autoimune Research Institute, Recife, Pernambuco, Brazil.
المصدر: International medical case reports journal [Int Med Case Rep J] 2022 Aug 26; Vol. 15, pp. 449-456. Date of Electronic Publication: 2022 Aug 26 (Print Publication: 2022).
نوع المنشور: Case Reports
اللغة: English
بيانات الدورية: Publisher: Dove Medical Press Country of Publication: New Zealand NLM ID: 101566269 Publication Model: eCollection Cited Medium: Print ISSN: 1179-142X (Print) Linking ISSN: 1179142X NLM ISO Abbreviation: Int Med Case Rep J Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Auckland, N.Z.] : Dove Medical Press
مستخلص: Background: Cutaneous involvement is the second-most frequent extraintestinal manifestation of inflammatory bowel disease, with pyoderma gangrenosum (PG) a particularly relevant form because of its frequency, morbidity, and recurrence. The limited number of clinical trials involving PG increases the challenge to gastroenterologists in the management of this condition.
Case Presentation: Four cases of atypical presentations of PG are reported. A 25-year-old patient with ulcerative colitis presented an extensive chronic ulcerative lesion on her left leg that was associated with significant bleeding; the intestinal disease was in remission under the use of azathioprine. The patient was on long-term use of 60 mg corticosteroid with no improvement in the skin disease; however, initiation of cyclosporine induced remission. In the second case, a 52-year-old woman was a carrier of Crohn's disease, with a history of partial colectomy. The patient's skin condition had evolved with a cutaneous lesion localized in the perineal region, buttocks, and colostomy pouch, simulating a case of impetigo, and this had been treated with antibiotic cycles without improvement. Lesion biopsy suggested a diagnosis of PG. Consequently, the patient was started on biological therapy with infliximab, and the PG regressed. In the third case, a 38-year-old woman with a history of pancolitis presented a picture of PG with an extensive and deep ulcerative lesion in the right breast. The lesion regressed after treatment with oral corticosteroid. The final case was a 44-year-old woman with Crohn's disease suffering from Crohn's disease pancolitis. The patient's condition evolved with a mixed pattern with pustules, bullae, and ulcerative lesions in the vulva, oral cavity, gluteus, right auricular region, scalp, and left flank, and was resolved by administration of adalimumab.
Conclusion: PG is an important and frequent manifestation of inflammatory bowel disease, with a spectrum of clinical variants, significant morbidity, and requiring a variety of therapeutic approaches.
Competing Interests: The authors declare no conflicts of interest in relation to this work.
(© 2022 Martinelli et al.)
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فهرسة مساهمة: Keywords: Crohn’s disease; extraintestinal manifestations; inflammatory bowel disease; pyoderma gangrenosum; ulcerative colitis
تواريخ الأحداث: Date Created: 20220902 Latest Revision: 20220907
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9427006
DOI: 10.2147/IMCRJ.S376915
PMID: 36051090
قاعدة البيانات: MEDLINE
الوصف
تدمد:1179-142X
DOI:10.2147/IMCRJ.S376915