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PubMed1983

Malignant pyoderma.

Malignant pyoderma is a rare, chronic, destructive ulcerating skin disease of unknown cause that affects young adults, usually males. In the seven previously reported cases, the lesions were distributed mainly about the head and neck region, and some were associated with neurological disturbances. The disease is progressive but responds to high doses of systemically administered steroids. We here describe an additional case and a follow-up of a previously reported case that was managed successfully with corticosteroid and cyclophosphamide therapy.

Adolescent↗
PubMed1984

Bullous pyoderma gangrenosum and multiple myeloma.

The previously unrecorded association of superficial bullous pyoderma and IgG-producing multiple myeloma is described. A rapid response of the cutaneous manifestations was achieved by treatment of the malignant paraproteinaemia.

Antibodies, Neoplasm↗
PubMed1985

Pyoderma gangrenosum treated with cyclosporin A.

A 49-year-old woman with a 14-year history of pyoderma gangrenosum unresponsive to a variety of systemic and topical treatments was given oral cyclosporin A (CyA), a potent immunosuppressive agent widely used in organ transplantation for the prophylaxis of acute graft-versus-host disease. Improvement and subsequent healing of the lesions was evident within 3 weeks of starting treatment and has continued for the duration of treatment (12 months).

Adult↗
PubMed1990

Development of folliculitis and pyoderma gangrenosum in association with abdominal pain in a patient following treatment with isotretinoin.

A 19-year-old man with severe acne developed extensive scalp folliculitis and later superficial pyoderma gangrenosum following treatment with isotretinoin. A cyclical neutropenia was noted and bone marrow findings suggested myelodysplasia. We believe that isotretinoin was implicated in the development of overt symptoms in this patient whose haematological condition was previously asymptomatic.

Abdominal Pain↗
PubMed1992

Pyoderma faciale in a patient with Crohn's disease.

We wish to report the progress of a patient with pyoderma faciale and Crohn's disease. The patient is interesting in that on two occasions the relapse in her skin condition coincided with the introduction of non-steroidal anti-inflammatory drugs. Therapy with isotretinoin was effective and well tolerated.

Adult↗
PubMed1992

Recalcitrant pyoderma gangrenosum--two cases successfully treated with cyclosporin A.

The successful use of cyclosporin A (CSA) in organ transplantation is now well established. In recent years its usefulness has extended to the treatment of cutaneous autoimmune disorders, including pyoderma gangrenosum (P.G.). We report two further cases of recalcitrant P.G., both associated with rheumatoid arthritis (R.A.) which responded to low dose CSA.

Aged↗
PubMed1995

Pyoderma gangrenosum complicating hysterectomy for fibroids.

Pyoderma gangrenosum is a destructive, non-infective ulceration of the skin. The case presented illustrates a rare but important presentation in a patient following a total abdominal hysterectomy and bilaterial salpingo-oophorectomy (TAH and BSO).

Female↗
PubMed1984

Immunologic and biochemical studies on a patient with pyoderma gangrenosum.

A patient with pyoderma gangrenosum without associated disease was studied. Routine investigations showed several abnormalities. High ESR, high alkaline phosphatase and glutamyl transferase (gamma-GT) levels, low iron and iron binding capacity, altered protein spectrum, presence of Staphylococcus aureus and group G hemolytic streptococci in ulcer culture, higher than normal antistreptolysin titers in the serum, and perivascular infiltration in the skin. Biochemical investigations aimed at finding any excessive hydrolytic activity did not reveal the presence of neutral proteases in circulation leaked out from PMN-leukocytes or elsewhere. Lysozyme levels were higher than normal, amylase and lipase levels were normal and 5' nucleotidase levels were below normal range. TCA-soluble polypeptides were present in the serum at levels two times higher than those in normal individuals. Immunochemical investigations showed the absence of immune complexes in the serum but presence of high amounts of C-reactive protein. Total complement activity was higher than normal and so was C3c level. Clq, C4, and C3d levels were within normal range. Biologic studies showed the presence of a factor in patient serum that made guinea pig skin hard, painful, erythematous, and eventually hairless, but not necrotic. A similar factor was either absent in normal serum or present in very low concentration. After salazopyrine treatment, all the above mentioned abnormalities corrected except that 5' nucleotidase activity remained slightly lower than normal, alkaline phosphatase levels remained slightly higher than normal, and C-reactive protein levels remained very high, though lower than those during intense disease activity.

Drug Combinations↗
PubMedDate not supplied

Leukocyte chemotaxis and pyoderma gangrenosum.

Leukocyte chemotaxis (in five patients with pyoderma gangrenosum) was studied using a modification of the Boyden chamber method. In all patients the chemotactic response was significantly lower than in the controls. This abnormal chemotaxis was a result of an intrinsic neutrophil dysfunction. No significant difference was detected between the chemotactic response of leukocytes from patients with minimal or no skin involvement and those from patients with extensive lesions.

Adult↗
PubMed1987

The management of pyodermas.

With the rising cost of medical services, it was decided to reassess the relevance of routine bacteriology investigations to the management of the individual patient with pyoderma. In both prospective and retrospective studies, it was found that laboratory reports were simply confirmatory and did not contribute to the management of the individual patient. A call is made for physicians to continuously look for cheaper ways of managing patients without necessarily causing any disservice to the patient.

Adolescent↗
PubMedDate not supplied

Trimethoprim-polymyxin B sulfate cream versus fusidic acid cream in the treatment of pyodermas.

One hundred patients with a clinical diagnosis of a primary or secondary superficial pyoderma were entered into a double-blind study. They were allocated treatment with either trimethoprim-polymyxin B sulfate cream or fusidic acid cream according to a fully randomized treatment code. Data suitable for evaluation were obtained from 87 patients, and statistical analysis revealed trimethoprim-polymyxin B sulfate (TP) cream to be significantly better than fusidic acid cream in alleviation several of the individual signs and symptoms associated with pyogenic infection of the skin as well as in reducing the overall severity score at the end of the 2-week study period.

Administration, Topical↗
PubMed1991

Scabies and Pyoderma in Lilongwe, Malawi. Prevalence and seasonal fluctuation.

From January 1988 to June 1989, data were collected daily on the patients who were seen at the Dermatology Clinic attached to the Kamuzu Central Hospital, Lilongwe, Malawi. Cases were diagnosed and patients were treated under the supervision of a dermatologist. A total of 34,002 patients were seen during the study period. Of these patients, 15,526 (45.7%) were children and 18,476 (54.3%) were adults. The prevalence of scabies was 40.4% in children and 31.6% in adults, whereas the prevalence of impetigo/bacterial skin infections was 26% in children and 10.4% in adults. Based on data accumulated for periods of 1 month, the incidence rate of scabies was highest during the cold, dry season (May-November) and the incidence rate of skin infection was highest during the hot, rainy season (December-April). Since the patients who were studied lived predominantly in rural settings, an explanation for the higher incidence rate of scabies during the cold season could be close body contact resulting from the overcrowding within the houses. The reason for the increase in the incidence rate of pyoderma during the rainy season might be linked to deficiencies in hygienic precautions. A community-based intervention strategy with children as its target population is proposed to combat these diseases.

Adult↗
PubMed1992

Pyoderma gangrenosum: associations revisited.

Fourteen cases of pyoderma gangrenosum were seen over a period of 24 years at the Hull Royal Infirmary Dermatology Department. Several associated conditions were found. Seven cases were associated with rheumatoid arthritis of which five were sero-positive, including one with Felty's syndrome. One case was associated with both ulcerative colitis and psoriasis; one with polycythemia rubra vera; two patients had diverticular disease including one who also had rheumatoid arthritis; one had positive syphilis serology. In three cases there was no significant associated disease identified. Ten out of the fourteen cases were women, indicating a female preponderance by a ratio of about 2F:1M; a figure similar to that stated by Seitzinger. The age of presentation ranged from 30 to 80 years.

Adult↗
PubMed1992

Treatment of pyoderma gangrenosum with clofazimine.

We report a case of pyoderma gangrenosum in a 80-year-old woman suffering from ulcerative colitis and treated with clofazimine. Significant improvement was evident within 5 days following commencement of therapy, complete healing occurred after only 4 weeks of treatment.

Aged↗
PubMed1994

Cephalic pyoderma gangrenosum (PG)-like lesions as a presenting sign of Wegener's granulomatosis.

BACKGROUND: Pyoderma gangrenosum (PG)-like lesions can be associated with Wegener's granulomatosis (WG); in rare instances, they could be the presenting sign of WG. The purpose of this study was to elucidate the relationship between these two disorders. METHODS: The clinical and histologic data from a case of WG with primary ulcerative lesions of the face were compared with five other cases previously reported in the literature. RESULTS: A predominance among young men was noted. In three patients the histology of the skin ulcerations was suggestive of WG, in the remaining three, including the case described, it was nonspecific. Two cases developed pulmonary WG after the skin lesions cleared, showing that the extent and severity of skin lesions do not necessarily correlate with the systemic disease. CONCLUSIONS: When the histology of the skin is nonspecific, the diagnosis of PG or PG-like lesions of the head and neck should not be considered definitive and the patients should be carefully monitored to rule out the possible presence of WG.

Adolescent↗
PubMedDate not supplied

Pyoderma gangraenosum caused by Rhizopus arrhizus.

A rare case of pyoderma gangraenosum caused by Rhizopus arrhizus is reported. The patient, a 50-year-old male farmer, was admitted to hospital complaining of gangrening and festering of the right upper arm with severe pain for nearly 2 months. A lesion was found on the inside of right upper arm. The central skin part of the lesion became black dry gangrenous, the periphery was deeply ulcerated with yellow-green pus. The necrotic crust, biceps, triceps and vessels inherited a histopathologically proven fungal infection. The fungus isolated was identified as Rhizopus arrhizus. The infection was successfully treated with itraconazole.

Humans↗