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1.
An. bras. dermatol ; 97(1): 121-123, Jan.-Feb. 2022. graf
Article in English | LILACS | ID: biblio-1360082
2.
An. bras. dermatol ; 96(5): 574-577, Sept.-Oct. 2021. graf
Article in English | LILACS | ID: biblio-1345148

ABSTRACT

Abstract Neutrophilic dermatoses encompass a wide spectrum of diseases characterized by a dense infiltration mainly composed of neutrophils. Neutrophilic dermatosis of the dorsal hands is currently considered a localized variant of Sweet syndrome. Cocaine abuse has been related to a wide range of mucocutaneous manifestations, including neutrophilic dermatoses such as pyoderma gangrenosum. The authors of this study present a patient with neutrophilic dermatosis of the dorsal hands, in which cocaine abuse was identified as a probable trigger.


Subject(s)
Humans , Sweet Syndrome/diagnosis , Sweet Syndrome/chemically induced , Pyoderma Gangrenosum , Cocaine-Related Disorders/complications , Dermatitis , Neutrophils
3.
Rev. Hosp. Ital. B. Aires (2004) ; 41(1): 26-30, mar. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1178336

ABSTRACT

El pioderma gangrenoso ampollar es una variedad infrecuente de pioderma gangrenoso, que se asocia en el 50-70% de los casos con trastornos oncohematológicos. Se comunica el caso de una paciente de 59 años, que consultó por fiebre y ampollas purpúricas de rápida progresión, con compromiso cutáneo mucoso. Con sospecha de una enfermedad neutrofílica, ampollar, o infección por gérmenes oportunistas, se realizó biopsia de piel para estudio histopatológico, inmunofluorescencia directa y cultivo. Los cultivos y la inmunofluorescencia directa fueron negativos, y la anatomía patológica reveló un denso infiltrado inflamatorio con predominio neutrofílico en dermis. Ante el diagnóstico de pioderma gangrenoso ampollar, se realizó una punción-aspiración de médula ósea cuyo resultado fue compatible con leucemia mieloide aguda. Se instauró tratamiento con corticosteroides sistémicos, a pesar de lo cual la paciente evolucionó desfavorablemente y falleció a los 15 días de su ingreso hospitalario. Este caso ilustra la asociación de esta enfermedad cutánea con trastornos oncohematológicos y el mal pronóstico que esto implica a corto plazo. (AU)


Bullous pyoderma gangrenosum is an infrequent type of pyoderma gangrenosum, associated with onco hematological diseases in 50-70% of cases. We present the case of a 59-year-old patient with fever and mucocutaneous hemorrhagic bullous of rapid progression. A biopsy for histopathology, direct immunofluorescence (DIF) and skin culture was made, considering the possibility of neutrophilic dermatoses, bullous dermatosis or an opportunistic infection. The results of both the culture and the DIF were negative. The histopathological examination of the specimen revealed a dense dermal polymorphic infiltrate composed primarily of neutrophils. Considering bullous pyoderma gangrenosum as a potential diagnosis, a bone-marrow biopsy was performed. This study revealed an acute myeloid leukemia. Although systemic corticosteroid therapy was begun, the patient presented an unfavorable evolution that led to her death 15 days after her admission at the hospital. This case shows the association between bullous pyoderma gangrenosum and onco hematological diseases. In addition, it highlights the poor prognosis related to these diseases in the short term. (AU)


Subject(s)
Humans , Female , Middle Aged , Leukemia, Myeloid, Acute/pathology , Pyoderma Gangrenosum/diagnosis , Paraneoplastic Syndromes/pathology , Respiration, Artificial , Azacitidine/therapeutic use , Myelodysplastic Syndromes/pathology , Acyclovir/administration & dosage , Methylprednisolone/administration & dosage , Vancomycin/administration & dosage , Cardiotonic Agents/therapeutic use , Ceftazidime/administration & dosage , Amphotericin B/administration & dosage , Imipenem/administration & dosage , Sweet Syndrome/etiology , Pyoderma Gangrenosum/etiology , Pyoderma Gangrenosum/pathology , Pyoderma Gangrenosum/drug therapy , Adrenal Cortex Hormones/therapeutic use , Meropenem/administration & dosage
4.
An. bras. dermatol ; 96(2): 188-195, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1248749

ABSTRACT

Abstract Pyoderma gangrenosum associated to the use of cocaine/levamisole is a rare condition associated to their consumption. Cocaine use is frequent in Colombia, and the substance is contaminated with levamisole, an anthelmintic that increases the psychotropic effects and enhances its side effects. We present three clinical cases of patients with ulcerated lesions, in which the diagnosis was pyoderma gangrenosum secondary to the use of cocaine contaminated with levamisole. This called the attention of the health staff to investigate the abuse of substances in gangrenous pyoderma and also evidence that the interruption of consumption was the basis of management.


Subject(s)
Humans , Pyoderma Gangrenosum/chemically induced , Pyoderma Gangrenosum/drug therapy , Cocaine/adverse effects , Cocaine-Related Disorders/complications , Levamisole , Colombia
5.
J. Health Biol. Sci. (Online) ; 9(1): 1-4, 2021. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1352364

ABSTRACT

Introdução: O pioderma gangrenoso é uma dermatose incomum, crônica e de apresentação clínica variável. Sua etiologia é indefinida, e seu tratamento não é bem estabelecido. O Adalimumabe é um anticorpo monoclonal humano contra o fator de necrose tumoral alfa (anti- TNF) que é raramente associado à disfunção cardíaca. Relato de Caso: Relatamos um caso de uma paciente com pioderma gangrenoso idiopático que, após duas doses de Adalimumabe, desenvolveu insuficiência cardíaca grave com miocardiopatia dilatada. Ela foi tratada com diurético de alça, betabloqueador e antagonista da enzima conversora da angiostensina. Após dois meses, encontrava-se sem queixas cardiorrespiratórias e com melhora da fração de ejeção. Conclusão: A miocardiopatia dilatada, apesar de ser manifestação rara do uso de fármacos anti -TNF deve ser considerada no diagnóstico diferencial de insuficiência respiratória após seu uso.


Introduction: Pyoderma gangrenosum is an unusual chronic dermatosis of mixed clinical presentation. Its etiology is unclear, and its treatment is not well established. Adalimumab is a human monoclonal antibody against the tumor necrosis factor alpha (anti TNF) which is rarely associated with cardiac dysfunction. Case Report: We report a case of a patient with idiopathic Pyoderma gangrenosum who developed severe heart failure with dilated myocardiopathy after two doses of Adalimumab. She was treated with loop diuretic, beta-blocker and angiostensin-converting enzyme antagonist. After two months, she was without cardiorespiratory complaints and with improvement in the ejection fraction. Conclusion: Dilated myocardiopathy, despite being a rare manifestation of the use of anti -TNF drugs should be considered in the differential diagnosis of respiratory failure after its use.


Subject(s)
Cardiomyopathy, Dilated , Pyoderma Gangrenosum , Heart Failure , Cardiomyopathies , Adalimumab , Antibodies, Monoclonal
6.
Rev. argent. cir. plást ; 26(3): 148-152, 20200900. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1151847

ABSTRACT

El pioderma gangrenoso es una patología infrecuente, de origen desconocido, caracterizada por la presencia de úlceras cutáneas de carácter necrótico, de aparición recurrente y rápida progresión. Puede manifestarse en cualquier área anatómica a partir de procesos quirúrgicos o traumáticos, que actúan como disparadores de la reacción autoinmune localizada. En pacientes con cirugía reciente, los signos y síntomas de esta patología se asemejan a una infección posoperatoria. El tratamiento se basa en el uso de corticosteroides e inmunosupresores, containdicando la conducta quirúrgica dado que la misma puede exacerbar la enfermedad. Presentamos un caso de pioderma gangrenoso en mastoplastía posbariátrica con inclusión de prótesis.


Pyoderma gangrenosum is a rare pathology of unknown origin, characterized by the presence of necrotic skin ulcers of recurrent appearance and rapid progression. It can emerge in any anatomic area, after surgeries or traumatic procedures which act as triggers of the localized immune reaction. In patients who have undergone recent surgeries, the signs and symptoms from this pathology resemble a post-operative infection. The treatment consist of corticosteroids and/or immunosuppressants. Surgical procedure is contraindicated since it can exacerbate the disease. We present a case of pyoderma gangrenosum in mastopexy with breast implant insertion post bariatric surgery.


Subject(s)
Humans , Female , Adult , Skin Diseases/diagnosis , Pyoderma Gangrenosum/pathology , Breast Implantation , Early Diagnosis
7.
Rev. enferm. UFPI ; 9: e9976, mar.-dez. 2020.
Article in Portuguese | LILACS, BDENF | ID: biblio-1371362

ABSTRACT

Objetivo: relatar o tratamento tópico usado em um caso de Pioderma Gangrenoso em uma mulher de 45 anos que apresentou manifestações clínicas típicas e que obteve boa resposta ao desbridamento cirúrgico, apesar do potencial risco de patergia, bem como apresentar breve revisão da literatura sobre este diagnóstico. Metodologia: estudo do tipo relato de experiência, descritivo, com abordagem qualitativa realizado na Clínica Médica de um Hospital Universitário, no período de abril a junho de 2018. Foi realizado com a autorização da paciente para utilização das suas imagens e informações. Os dados foram obtidos por meio do prontuário, avaliação direta das lesões e registros fotográficos para o acompanhamento da evolução do processo cicatricial. Resultados: constatou-se melhora significativa do processo de cicatrização após desbridamento cirúrgico permitindo, assim, a utilização de curativo com cobertura especial que não seria recomendável sem o procedimento de retirada do tecido necrótico. Conclusão: Os resultados demonstrataram que o desbridamento cirúrgico associado a terapia tópica e sitêmica permitiram uma boa evolução das lesões, embora estudos geralmente recomendem evitar esse desbridamento devido ao risco potencial de patergia.


Objective: To report the topical treatment used in a case of Pyoderma Gangrenosum in a 45-year-old woman who presented typical clinical manifestations and who had a good response to surgical debridement, despite the potential risk of pathergia, as well as to briefly review the literature on this diagnosis. Methodology: it is a descriptive experience report study with a qualitative approach conducted at the Medical Clinic of a University Hospital, from April to June 2018. It was performed with the patient's authorization to use their images and information. Data were obtained through medical records, direct evaluation of the lesions and photographic records to follow the evolution of the healing process. Results: There was a significant improvement in the healing process after surgical debridement, thus allowing the use of a dressing with special coverage that would not be recommended without the necrotic tissue removal procedure. Conclusion: The results showed that surgical debridement associated with topical and systemic therapy allowed a good evolution of the lesions, although studies generally recommend avoiding this debridement due to the potential risk of pathergia.


Subject(s)
Colitis, Ulcerative , Pyoderma Gangrenosum , Debridement
8.
An. bras. dermatol ; 95(2): 203-206, Mar.-Apr. 2020. graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1130837

ABSTRACT

Abstract Hidradenitis suppurativa is a chronic inflammatory skin disease, which affects 1% of the population, being more common in young, obese and smokers, and mainly affects armpits and groin, with formation of pustules, nodules, abscesses, scars and fistulas. Recently, its association with other autoimmune diseases such as psoriasis, psoriatic arthritis, pyoderma gangrenosum, pyogenic arthritis and ulcerative colitis have been reported. These associated forms are usually resistant to standard treatment, with immunobiologicals as promising therapy. The case of a rare form of association is reported, with only one case previously described in the literature: psoriasis arthritis, pyoderma gangrenosum, acne and hidradenitis suppurativa.


Subject(s)
Humans , Female , Young Adult , Arthritis, Psoriatic/pathology , Pyoderma Gangrenosum/pathology , Hidradenitis Suppurativa/pathology , Acne Vulgaris/pathology , Autoimmune Diseases/pathology , Syndrome
9.
Med. interna (Caracas) ; 36(2): 105-110, 2020. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1140295

ABSTRACT

El pioderma gangrenoso es una dermatosis neutrofílica poco común que se presenta como un desorden inflamatorio y ulcerativo de la piel. Más de la mitad de los pacientes que desarrollan esta afección, tienen asociada una enfermedad sistémica subyacente. Caso clínico: paciente femenina de 79 años de edad, previamente sana, quien acude por presentar desde 4 días antes, flictenas violáceas, de contenido serohemático que se decapitan dejando úlcera superficial de fondo eritematoso, y luego profundizaron, no mejoraron con antibióticos por lo que se toma biopsia cutánea que reporta hallazgos compatibles con pioderma gangrenoso; se inició tratamiento con corticoides tópicos y sistémicos evidenciando mejoría de las lesiones. Durante la investigación etiológica se constató descenso de todas las líneas hematológicas y la biopsia de médula ósea mostró síndrome mielodisplásico con displasia unilínea de bajo grado. Discusión: El pioderma gangrenoso de tipo buloso, está comúnmente asociado a enfermedades hematológicas; en pacientes sin alteraciones hematológicas iniciales, debe haber un seguimiento estricto enfocado en la búsqueda de estos trastornos en un lapso de hasta 10 años. Se trata con fármacos inmunosupresores e inmunomoduladores. Conclusiones: ante la presencia de pioderma gangrenoso se debe sospechar síndrome mielodisplásico(AU)


Pyoderma gangrenosum is an uncommon neutrophilic dermatosis that presents as an inflammatory and ulcerative disorder of the skin. More than half of patients with pyoderma gangrenosum develop the disorder in association with an underlying systemic disease. Clinical case: 79-year-old female patient, previously healthy, who consulted for a period of 4 days, purplish skin lesions, which, once decapitated, showed a superficial ulcer that did not improve with broad spectrum antibiotics. The biopsy is taken, which reports findings compatible with pyoderma gangrenosum, so treatment with topical and systemic corticosteroids is started showing improvement of the lesions. During the diagnostic workup, pancytopenia was verified and, after ruling out other etiologies, bone marrow biopsy was performed, which allowed the diagnosis of lower-risk myelodysplastic syndrome with single lineage dysplasia. Discussion: Bullous pyoderma gangrenosum is most commonly seen in patients with hematologic disease; due to the strong association between bullous PG and hematologic disease, patients who present without an associated hematologic disorder should be followed closely for the development of a hematologic disorder. Conclusion: Etiological search for pyoderma gangrenosum allows early diagnosis and timely treatment of the underlying disease(AU)


Subject(s)
Humans , Female , Aged , Skin Diseases , Skin Ulcer , Myelodysplastic Syndromes , Pyoderma Gangrenosum , Hematologic Diseases , Biopsy , Adrenal Cortex Hormones/therapeutic use , Immunosuppressive Agents
10.
Article in English | WPRIM | ID: wpr-881513

ABSTRACT

@#INTRODUCTION: Pyoderma gangrenosum is a rare neutrophilic dermatoses in children of unknown etiology. Its occurrence may be associated with a systemic condition. In most cases, diagnosis is late and treatment is sometimes refractory to conventional therapies especially if the underlying disorder is undetected. CASE REPORT: A 3-year-old Filipino male presented with a one-year history of extensive ulcers over the nape, chest, back and lower extremities which started as a solitary painful pustule over the right gluteal area. Central healing was observed with cribriform scarring. Patient was previously treated as a case of skin infection without success. Significant laboratory findings showed severe anemia, neutrophilia, increased ferritin and increased ESR. Initial hemoglobin electrophoresis showed normal profile with mild microcytic anemia. Bacterial culture and ANA (anti-nuclear antigen) were negative. A course of oral prednisone (1-2mkd) and dapsone (2mkd) were given for a month with no improvement of the lesions. Folic acid alone was started at 5mg per day for anemia. After 2 weeks, lesions significantly improved. Three years later, upon repeat hemoglobin electrophoresis test, patient was diagnosed with alpha-thalassemia trait. Folic acid was given as mainstay therapy. Lesions healed with characteristic cribriform scarring. CONCLUSION: This is a rare case of a Filipino child who initially manifested with pyoderma gangrenosum and eventually diagnosed with alpha-thalassemia trait. Due to serious cosmetic sequelae of pyoderma gangrenosum, it is important to find and treat the underlying systemic disorder to stop progression of this debilitating and disfiguring dermatosis


Subject(s)
Pyoderma Gangrenosum , alpha-Thalassemia , Ulcer , beta-Thalassemia , Family
11.
Rev. bras. cir. plást ; 34(4): 567-570, oct.-dec. 2019. ilus
Article in English, Portuguese | LILACS | ID: biblio-1047930

ABSTRACT

O pioderma gangrenoso (PG) é doença inflamatória da pele, que pode se desenvolver espontaneamente, associado a certas doenças sistêmicas e neoplásicas, ou ao trauma cirúrgico, incluindo os das mamas. Há relatos cada vez mais frequentes, considerando o aumento desse procedimento nos dias atuais. A manifestação clínica das úlceras é característica e deve ser lembrada nas evoluções cicatriciais desfavoráveis com intensa reação inflamatória, perdas teciduais, secreção sanguinolenta e/ ou purulenta, fundo granuloso e bordas elevadas. Relatase o caso de paciente que teve pioderma gangrenoso após mamoplastia redutora. Respondeu ao corticosteroide sistêmico, e vem evoluindo sem recidivas até o momento.


Pyoderma gangrenosum (PG) is an inflammatory disease of the skin that may develop spontaneously. It is associated with certain systemic and neoplastic diseases, including those of the breasts. PG is also associated with surgical trauma. It has been increasingly reported, along with the increase in the incidence of reduction mammoplasty procedures. The clinical manifestation of ulcers is characteristic of PG and it should be considered in cases of poor healing with intense inflammatory reaction, tissue loss, bloody and/ or purulent secretion, granular background, and lesions with high edges. We describe a patient who developed PG after reduction mammoplasty. She has since responded to systemic corticosteroids and has had no relapse to date.


Subject(s)
Humans , Female , Middle Aged , History, 21st Century , Postoperative Complications , Skin Diseases , Autoimmune Diseases , Mammaplasty , Pyoderma Gangrenosum , Diagnosis, Differential , Postoperative Complications/surgery , Postoperative Complications/therapy , Skin Diseases/surgery , Skin Diseases/complications , Skin Diseases/therapy , Autoimmune Diseases/diagnosis , Autoimmune Diseases/therapy , Surgical Procedures, Operative , Surgical Procedures, Operative/methods , Mammaplasty/methods , Pyoderma Gangrenosum/surgery , Pyoderma Gangrenosum/complications , Pyoderma Gangrenosum/therapy
12.
An. bras. dermatol ; 94(6): 713-716, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054898

ABSTRACT

Abstract Hyperzincemia and hypercalprotectinemia is a rare inflammatory disease caused by a mutation in the PSTPIP1 gene, with a dysregulation of calprotectin metabolism. Calprotectin is a zinc-binding protein with antimicrobial properties and pro-inflammatory action. The authors report the case of a 20 year-old girl with cutaneous ulcers comparable with pyoderma gangrenosum, growth failure and chronic anemia, who was given the diagnosis of hyperzincemia and hypercalprotectinemia. Measurement of serum zinc and calprotectin concentrations are indicated in these cases.


Subject(s)
Humans , Female , Young Adult , Pyoderma Gangrenosum/pathology , Metal Metabolism, Inborn Errors/pathology , Zinc/blood , Prednisolone/therapeutic use , Treatment Outcome , Cyclosporine/therapeutic use , Leukocyte L1 Antigen Complex/blood , Dermatologic Agents/therapeutic use , Glucocorticoids/therapeutic use , Metal Metabolism, Inborn Errors/drug therapy
13.
An. bras. dermatol ; 94(6): 729-743, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054881

ABSTRACT

Abstract Pyoderma gangrenosum is a neutrophilic dermatosis characterized by chronic ulcers due to an abnormal immune response. Despite the existence of diagnostic criteria, there is no gold standard for diagnosis or treatment. In Latin America, recognizing and treating pyoderma gangrenosum is even more challenging since skin and soft tissue bacterial and non-bacterial infections are common mimickers. Therefore, this review aims to characterize reported cases of pyoderma gangrenosum in this region in order to assist in the assessment and management of this condition. Brazil, Mexico, Argentina, and Chile are the countries in Latin America that have reported the largest cohort of patients with this disease. The most frequent clinical presentation is the ulcerative form and the most frequently associated conditions are inflammatory bowel diseases, inflammatory arthropaties, and hematologic malignancies. The most common treatment modalities include systemic corticosteroids and cyclosporine. Other reported treatments are methotrexate, dapsone, and cyclophosphamide. Finally, the use of biological therapy is still limited in this region.


Subject(s)
Humans , Pyoderma Gangrenosum/diagnosis , Pyoderma Gangrenosum/pathology , Prevalence , Pyoderma Gangrenosum/therapy , Pyoderma Gangrenosum/epidemiology , Diagnosis, Differential , Latin America/epidemiology
14.
Article in English | WPRIM | ID: wpr-759709

ABSTRACT

We report a rare case of a bullous type of pyoderma gangrenosum in a pediatric patient. A 3-year-old female patient visited our department with recurrent hemorrhagic bullae and erosive patches for 1 year. Skin biopsy revealed a subepidermal blister with diffuse neutrophilic infiltrations in the dermis. The diagnosis of bullous pyoderma gangrenosum was made by exclusion of other diseases via bacterial culture, laboratory, and immunofluorescence studies. The skin lesions responded well to a low dose of systemic corticosteroid, but the lesions recurred frequently.


Subject(s)
Biopsy , Blister , Child , Child, Preschool , Dermis , Diagnosis , Female , Fluorescent Antibody Technique , Humans , Neutrophils , Pyoderma Gangrenosum , Pyoderma , Skin
15.
Rev. bras. cir. plást ; 33(4): 590-594, out.-dez. 2018. ilus
Article in Portuguese | LILACS | ID: biblio-980168

ABSTRACT

O pioderma gangrenoso (PG) é uma dermatose neutrofílica inflamatória, de etiologia desconhecida. O PG é idiopático em 25-50% dos casos. Em aproximadamente 50% dos casos tem sido descrita a associação com doenças sistêmicas, tais como: doença de Crohn, gamopatias monoclonais, artrites soropositivas, colagenoses, doença de Behcet, granulomatose de Wegener, doenças mieloproliferativas e infecciosas, principalmente hepatites e Aids. Clinicamente, apresenta quatro variantes: ulcerada, bolhosa, vegetante e pustulosa. A forma mais frequente é a ulcerativa, que se inicia com pápula ou nódulo e evolui rapidamente para lesões ulceradas e dolorosas. Em até 25% dos casos de PG, o surgimento de novas lesões pode ser desencadeado por traumas, tais como picadas de insetos, injeções intravenosas e biópsia - fenômeno conhecido por patergia. Nesse trabalho, é apresentado um caso de PG extenso das mamas em pós-operatório de mamoplastia redutora, de difícil diagnóstico; iniciado na evolução pós-operatória em outro serviço. Devido à quebra da relação médico-paciente, vem procurar nosso serviço. Apresentou ótima resposta ao tratamento com corticoterapia (corticoterapia intra e perilesionais com triancinolona) no ato do desbridamento, e introdução de corticoterapia via oral (prednisona) em esquema escalonado de desmame.


Pyoderma gangrenosum (PG) is an inflammatory neutrophilic dermatosis of unknown etiology and is idiopathic in 25%- 50% cases. In approximately 50% of PG cases, an association with systemic diseases, such as Crohn's disease, monoclonal gammopathies, seropositive arthritis, collagenosis, Behcet's disease, Wegener's granulomatosis, and myeloproliferative and infectious diseases (mainly hepatitis and AIDS), has been described. Clinically, PG presents four variants: ulcerated, bullous, vegetative, and pustular. The most frequent form is ulcerative, which begins as a papule or nodule and evolves rapidly into ulcerated and painful lesions. In approximately 25% of PG cases, the onset of new lesions can be triggered by traumas such as insect bites, intravenous injections, and biopsy, a phenomenon known as pathergy. Here, we present a case of extensive PG of the breasts following reductive mammoplasty surgery. It was a difficult case to diagnose and was initiated in the postoperative period of another service. Due to the breakdown of the doctor-patient relationship, the patient approached us for assistance. The patient showed an excellent response to corticotherapy (intra and perilesional corticotherapy with triamcinolone) during debridement and oral steroid (prednisone) therapy in the weaning phase.


Subject(s)
Humans , Female , Middle Aged , Mammaplasty/adverse effects , Mammaplasty/methods , Pyoderma Gangrenosum/surgery , Pyoderma Gangrenosum/complications , Pyoderma Gangrenosum/drug therapy , Reconstructive Surgical Procedures/adverse effects , Reconstructive Surgical Procedures/methods , Physician-Patient Relations , Postoperative Complications , Esthetics
16.
Rev. bras. cir. plást ; 33(3): 414-418, jul.-set. 2018. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-965621

ABSTRACT

Introdução: O pioderma gangrenoso (PG) corresponde a uma dermatose autoimune crônica e rara. Sua base etiológica ainda permanece pouco conhecida, sendo idiopático em 25 a 50% dos casos, nos demais está associado com doenças sistêmicas de fundo autoimune, tem uma incidência de 2 a 3 casos em 1 milhão de habitantes por ano. No Brasil, este índice é de 0,38 casos por 10.000 atendimentos, as mais acometidas são as mulheres entre a segunda e quinta década de vida. O quadro clínico é variável, sendo que a forma ulcerosa, que surge sobre uma cicatriz prévia, é a mais prevalente. Relato de Caso: Paciente do sexo feminino, 39 anos de idade, previamente hígida, foi submetida à mamoplastia redutora, evoluiu com úlcera necrótica em cicatriz vertical de mama esquerda. Realizado desbridamento de tecidos desvitalizados, prescrita antibioticoterapia, apresentando piora importante da lesão, sendo considerada a hipótese de PG. Iniciado tratamento com corticoterapia oral e tópica com remissão do quadro. Conclusões: O PG representa um desafio no diagnóstico e, geralmente, demonstra a dificuldade diagnóstica, podendo ser confundido com infecção do sítio cirúrgico.


Introduction: Pyoderma gangrenosum (PG) is a chronic and rare autoimmune dermatosis. Its etiology remains poorly understood, being idiopathic in 25 to 50% of cases; in others, it is associated with systemic diseases with autoimmune background and has an incidence of 2 to 3 cases per 1 million per year. In Brazil, the rate is 0.38 cases per 10,000 clinical visits, and women between the second and fifth decades of life are the most affected. The clinical presentation is variable, and the ulcerous form, which appears on a previous scar, is the most prevalent. Case Report: A 39-year-old, previously healthy female underwent reduction mammoplasty, and later developed a necrotic ulcer on a vertical left breast scar. Debridement of devitalized tissue was performed, with significant worsening despite antibiotic therapy. The appearance suggested PG. Treatment with oral and topical corticosteroids was then initiated with remission. Conclusions: PG represents a diagnostic challenge, and can be confused with surgical site infection.


Subject(s)
Humans , Female , Adult , Pyoderma Gangrenosum/surgery , Oxygen Inhalation Therapy/methods , Patients , Wounds and Injuries/drug therapy , Breast/surgery , Mammaplasty , Pyoderma Gangrenosum , Adrenal Cortex Hormones/therapeutic use , Reconstructive Surgical Procedures/methods , Anti-Bacterial Agents/therapeutic use
17.
An. bras. dermatol ; 93(4): 605-607, July-Aug. 2018. graf
Article in English | LILACS | ID: biblio-1038275

ABSTRACT

Abstract: Pyoderma gangrenosum (PG) is an uncommon neutrophilic dermatosis, with variable clinical features, nonspecific histopathology and multifactorial pathogenesis, posing a challenging diagnosis for the dermatologist. Pyoderma gangrenosum is a diagnosis of exclusion and should be included in the differential diagnoses of the verrucous syndrome. We report a granulomatous variant affecting the face.


Subject(s)
Humans , Male , Aged , Warts/pathology , Pyoderma Gangrenosum/pathology , Face/pathology , Facial Dermatoses/pathology , Syndrome , Diagnosis, Differential
19.
Rev. méd. Chile ; 146(4): 534-537, abr. 2018. graf
Article in Spanish | LILACS | ID: biblio-961426

ABSTRACT

An assortment of clinical and laboratory abnormalities may occur as paraneoplastic syndromes in lymphomas. Rheumatological and dermatological manifestations such as paraneoplastic arthritis and pyoderma gangrenosum must be underscored. We report a 28 years old woman who developed pyoderma gangrenosum and two years later presented with arthritis of knees and ankles associated with panniculitis interpreted as erythema induratum that was pathologically confirmed. She developed a reactivation of pyoderma gangrenosum, that was refractory to treatment. Complementary studies showed a pulmonary nodule and a right paravertebral mass with involvement of the psoas muscle. Biopsies of both masses and a new pathological skin study demonstrated a large B-cell non-Hodgkin's lymphoma.


Subject(s)
Humans , Female , Adult , Paraneoplastic Syndromes/complications , Arthritis/etiology , Lymphoma, Non-Hodgkin/complications , Panniculitis/etiology , Pyoderma Gangrenosum/etiology , Paraneoplastic Syndromes/diagnosis , Paraneoplastic Syndromes/drug therapy , Arthritis/diagnosis , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/drug therapy , Panniculitis/diagnosis , Pyoderma Gangrenosum/drug therapy
20.
An. bras. dermatol ; 93(1): 133-134, Jan.-Feb. 2018. graf
Article in English | LILACS | ID: biblio-887134

ABSTRACT

Abstract: Pyoderma gangrenosum may precede, coexist or follow diverse systemic diseases. The bullous variety is usually associated with hematologic disorders. From 31 patients with pyoderma gangrenosum diagnosed in our hospital during 10 years, only 2 presented with the bullous type. One patient had previous diagnosis of chronic myeloid leukemia. Both had fast-progressive, painful lesions, and both showed an excellent response to systemic corticosteroids. In less than 3 months the lesions recurred simultaneously with the progression of chronic myeloid leukemia in one patient and with the initial diagnosis of acute myeloid leukemia in the other one. They died in less than four weeks. These findings emphasize the importance of its timely diagnosis. Cutaneous lesions could be the first predictor of an underlying disease.


Subject(s)
Humans , Male , Female , Adult , Aged , Leukemia, Myeloid/complications , Skin Diseases, Vesiculobullous/complications , Pyoderma Gangrenosum/complications , Hematologic Neoplasms/complications , Recurrence , Skin Diseases, Vesiculobullous/pathology , Pyoderma Gangrenosum/pathology , Fatal Outcome
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