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PubMed1998

Pyoderma gangrenosum following cytosine arabinoside, aclarubicin and granulocyte colony-stimulating factor combination therapy in myelodysplastic syndrome.

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis, which may be associated with systemic conditions such as hematologic disorders. We present a patient who had been diagnosed as having myelodysplastic syndrome associated with PG at onset, in whom a febrile ulcerative skin lesion developed following cytosine arabinoside, aclarubicin and granulocyte colony-stimulating factor (G-CSF) combination chemotherapy in the course of the disease. Skin biopsy revealed dense neutrophilic infiltrate in the dermis with central epidermal ulceration, consistent with the diagnosis of PG. Oral prednisolone was effective for the skin lesion. In this case, G-CSF application may participate in the recurrence of PG.

Aclarubicin↗
PubMed1982

Deposits of complement and immunoglobulins in vessel walls in pyoderma gangrenosum.

Previous immunofluorescence studies on pyoderma gangrenosum (PG) proved negative. Biopsies from the ulcer edge of 8 patients with PG were examined by immunofluorescence microscopy. Deposits of complement C3 were seen in the vessel walls of all samples, IgM in three and IgA in one. Granular deposits of C3 were seen at the dermal--epidermal junction in 2 patients. Biopsies from clinically normal skin of 6 of the patients were negative. It is suggested that deposition of immune complexes in the dermal vessel walls may play a role in the pathogenesis of PG.

Blood Vessels↗
PubMed1996

Common bacterial pyodermas. Taking aim against the most likely pathogens.

Primary pyodermas are frequently encountered in primary care practice. Staphylococci and streptococci are the most common causes of infection, although a number of organisms may be found in particular clinical settings. Penicillin, semisynthetic penicillins, and erythromycin are the mainstays of treatment. Even though culture for specific pathogens is performed, treatment is often empirical. Therefore, familiarity with these common lesions and their management aids in efficient and effective treatment.

Anti-Bacterial Agents↗
PubMedDate not supplied

Efficacy of once-daily clindamycin hydrochloride in the treatment of superficial bacterial pyoderma in dogs.

Twenty-one dogs with canine superficial bacterial pyoderma were treated with clindamycin at a dosage of approximately 11 mg/kg body weight, q 24 hours, given orally for 14 to 42 days. All dogs were reexamined on days 14, 28, and, if necessary, 42 and given a clinical score of excellent (i.e., complete remission), good (i.e., primary lesions resolved but secondary lesions evident), fair (i.e., partial improvement but primary lesions still evident), or poor (i.e., no improvement or worsening of the lesions). A clinical score of excellent was obtained in 71.4% (15/21) of the dogs in this study within 14 to 28 days.

Administration, Oral↗
PubMed2000

Parastomal pyoderma gangrenosum: clinical features and management.

BACKGROUND: The importance of pyoderma gangrenosum (PG) as a cause of ulceration around abdominal stomas is not well recognized. OBJECTIVE: Our purpose was to describe the incidence, clinical and histologic features, disease associations, and possible risk factors for parastomal PG. METHODS: A clinic, run by a dermatologist and two stoma nurses, was created. Five hundred patients approached by postal questionnaire were invited to attend if they had skin problems. In addition, local surgical, dermatologic, and nursing services were invited to refer patients with parastomal skin problems. Cases of parastomal PG were identified, investigated, and treated. RESULTS: The annual incidence of parastomal PG in the questionnaire-based cohort of patients was 0.6% (3 patients). An additional 23 patients with the condition were seen. No consistent hematologic, biochemical, immunologic, microbiological or histologic abnormalities were identified. Local skin damage did not appear to be an important trigger for parastomal PG. The condition is recurrent in one third of cases. Topical tacrolimus (0.3% in carmellose sodium paste) has been effective in 4 patients. CONCLUSION: Parastomal PG is far more common than previous reports would suggest, and it may be associated with diseases other than inflammatory bowel disease.

Abdomen↗
PubMed2000

[Pyoderma gangrenosum and breast cancer: a new case].

We report here a new case of pyoderma gangrenosum (PG) associated with a breast cancer in a 39-year-old woman. We only found in literature three other reports of this rare entity which seems usually to be associated with monoclonal gammopathy, gastro-intestinal diseases such as Crohn's disease, chronic ulcerative colitis, leukemias or rheumatologic diseases. A commun hapten between of tumor and skin may explain the origin of this inflammatory lesion. In our case, PG could be a paraneoplastic syndrome.

Adult↗
PubMed2000

Pyoderma gangrenosum and myelodysplastic syndrome.

Pyoderma gangrenosum (PG) is a painful, often rapidly progressive, ulcerating skin disorder frequently associated with systemic diseases. We report the case of a patient with PG and an anemia. A bone marrow biopsy showed changes consistent with one of the myelodysplastic syndromes, refractory anemia with ringed sideroblasts. Patients with PG and anemia should have bone marrow biopsy if no cause of anemia is readily apparent.

Anemia, Refractory↗
PubMed2000

Superficial granulomatous pyoderma.

We report the case of a 30-year-old man who, from the age of 16, presented with abscess-type lesions that turned into ulcers with a torpid course and with histopathologic characteristics of superficial granulomatous pyoderma. The patient has been followed for 6 years, during which time the only treatment necessary to prevent recurrence of lesions has been the administration of different doses of minocycline.

Adult↗
PubMed2001

[Superficial pyoderma requiring oral antibiotic therapy: fusidic acid versus pristinamycin]].

OBJECTIVE: This study was aimed to compare the clinical and antibacterial efficacy of fusidic acid 500 mg twice a day, per os, over 7.5 days) to pristinamycin 1 g twice a day, per os, over 10 days). METHODS: Patients aged over 18, suffering from a superficial pyoderma requiring antibiotherapy and having given their informed consent were enrolled in a controlled, multicentre, double blind double dummy, parallel groups study. From day 0 to day 10, the patients received the randomised treatment. Those who were cured at day 11 had a visit at day 25 without any treatment between day 11 and day 25. A swab was performed on days 0, 11 and 25. The two treatment groups were compared in terms of efficacy, safety and global cost. RESULTS: 334 patients seen in dermatologic consultation were included in the study. 313 patients were analysed on an intent-to-treat basis. 158 received fusidic acid (FA) and 155 were treated with pristinamycin (P). At D11, 126 patients were cured in the FA group (79.7%) and 118 in the P group (76.1%) (p = 0.44). The bacteriological success rate was 85.2% in the FA group and 82.7 in the P group (p = 0.67). The recovery was confirmed in 92.6% of the FA patients and 90.4% of the P patients at D25 (p = 0.56). Digestive tolerance was better with fusidic acid than with pristinamycin. In economic terms, fusidic acid was cheaper than pristinamycin: 443 French francs in the FA group versus 545 FF in the P group. CONCLUSION: Therefore we conclude that an oral course of 7.5 days with fusidic acid is an efficient and cheaper alternative to a treatment with pristinamycin over 10 days.

Administration, Oral↗
PubMed2001

Suspected induction of a pyoderma gangrenosum-like eruption due to sulpiride treatment.

A case of a pyoderma gangrenosum (PG)-like eruption due to the antipsychotic drug sulpiride, a form of risperidone, is described. The contribution of sulpiride to the etiology of the PG-like lesion is based on the reduction and healing of the ulcer upon cessation of the drug and the formation of a bulla following the drug's re-administration. The literature on drug-induced PG or PG-like eruptions is discussed. The selectivity of sulpiride for dopamine receptors and its limited effect on other neuronal pathways differentiates sulpiride from other types of antispychotic drugs commonly used in Israel, including phenothiazine, butyrophenone, and thioxanthene. Adverse systemic and cutaneous reactions to sulpiride and to risperidone are described. To our knowledge, this is the first report of a PG-like eruption due to the former.

Antipsychotic Agents↗
PubMed2001

[A non-infectious pyodermatitis: Pyoderma gangrenosum].

Pyoderma gangrenosum (PG) is a rare chronic inflammatory skin disease characterized by the recurring development of necrotizing and painful ulcers. The skin lesions appear spontaneously or after minor traumatic injuries. Sites of predilection include the lower limbs and the trunk but any part of the body may be affected. PG is not an infectious disease; although the etiology is not completely understood, an immune disturbance is certainly involved. An underlying systemic disorder is associated in up to 50% of the cases, specially inflammatory bowel diseases, arthritis, paraproteinemias and hematologic malignancies. Chronic venous or arterial ulcers as well as bacterial gangrene are the most frequent false diagnoses. A right diagnosis, based upon the distinctive clinical features and a compatible histology, is essential to avoid surgical procedure that often tends to exacerbed the process. Because of its persistent and recurrent nature, systemic long-term therapy based upon corticosteroids associated with sulfones or immunosuppressive agents is required.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Pyoderma gangrenosum.

Pyoderma gangrenosum (PG) is an idiopathic, painful and destructive condition that usually presents as an ulceration on the pretibial region of the legs. It primarily affects patients with inflammatory bowel disease, arthritis, myeloproliferative disorders and chronic hepatitis, and occasionally affects patients with other conditions, but it may also occur without any associated illness. Since there are no specific serologic or histologic markers for PG, it must be diagnosed clinically. Treatment usually involves immunosuppressant therapy as well as treatment of the underlying disease. The course of PG is unpredictable, and prognosis depends on the extent of the skin lesions at the time of diagnosis, underscoring the need for early and aggressive management.

Adrenal Cortex Hormones↗
PubMed2001

[A case of pyoderma gangrenosum after mitral valve replacement].

A 48-year-old male with treated hypothyroidism underwent mechanical valve replacement for mitral valve regurgitation. After the operation, the patient developed progressive median chest wound ulceration. The wound did not heal with conventional therapies for mediastinitis such as administration of antibiotics, debridement of necrotic tissue or continuous irrigation. The entire surgical wound opened spontaneously. Bacterial cultures yielded negative and the wound biopsy specimen revealed non-specific inflammatory change. The anti-TSH receptor antigen level was high. Pyoderma gangrenosum based on auto-immune deficiency was diagnosed and high dose corticosteroid therapy was started. The wound healed completely in 5 months.

Autoantibodies↗
PubMed2001

[Postoperative pyoderma gangrenosum developing after cholecystectomy and placement of a stoma].

Pyoderma gangrenosum is a serious necrotizing skin disease frequently associated with diseases of internal organs. In rare instances it may develop after surgical operations or minor injuries causing traumatization of the skin. Our patient developed the disease immediately after cholecystectomy at the site of the scar on the abdomen, and disseminated foci developed also at other sites of the body. In the second patient it developed in the region of the stoma soon after its establishment during development of ulcerative colitis. Skin manifestations healed after systemic combined immunosuppressive treatment.

Adult↗
PubMed2000

Pyoderma gangrenosum: a case study for pain management in dermatology nursing.

The Joint Commission on Accreditation of Healthcare Organizations recently approved new standards for pain assessment and management. These standards will influence the practice of dermatology nursing in every setting. Nurses play a critical role in the care of patients with pain. Pyoderma gangrenosum is used as the basis for applying the new pain standards.

Acetaminophen↗
PubMed2001

[Ulcerative colitis concomitant with pyoderma gangrenosum and erythema nodosum--presentation of two cases].

Authors present case of a 28-year old woman with skin symptoms of pyoderma gangrenosum and ulcerative colitis seriously advanced. The patient benefited from wide resection of the colon and steroid therapy. The other patient was 23-year old woman with ulcerative colitis concomitant with skin changes of erythema nodosum. In this case steroid therapy gave also a very good effect. We tried to find pathogenetic connection between these diseases based on the reports from the medical literature.

Adult↗
PubMed2002

Parastomal pyoderma gangrenosum: a case report and literature review.

Parastomal pyoderma gangrenosum (PPG) is an exceedingly rare disease process most often observed in inflammatory bowel disease patients with an ileostomy. Fewer than 50 cases have been reported in the medical literature. The incidence is 0.6 per cent of patients with ileostomy and inflammatory bowel disease. The rarity of the disease leads to misdiagnosis and mistreatment of the lesion. The intense pain and disruption of ostomy function greatly impair affected individuals beyond the limit of their underlying disease. Current best care practices observed in small study series indicate long-term intensive medical therapy aimed at systemic disease suppression to optimize PPG wound healing. Our patient had no signs of active Crohn disease at the time of PPG presentation. She was initially treated with minimal wound debridement and intralesional triamcinolone. Finally under the care of an enterostomal/wound care therapist the patient achieved excellent PPG resolution in 6 months.

Adult↗