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[Pyoderma gangrenosum after a pacemaker implantation--case report].

We are presenting a 71-years old male patient with chronic skin lesions that appeared at multiple site of pacemaker implantations in the upper thorax. In spite of many treatment trials, no significant improvements were accomplished. Expanded dermatological tests including serial histopathological examinations were necessarily performed. Based on test results and clinical presentations, the diagnosis of pyoderma gangrenosum was made. Immediate steroid therapy allowed dramatic improvement of the chronic inflammatory condition. The patient is still undergoing a close dermatological and cardiological follow-up. Replacement of the pacemaker into the abdomen is currently being considered.

Aged↗

Pyoderma gangraenosum associated with autoimmune thyreopathy and hyperandrogenic syndrome.

An unusual clinical appearance and course of pyoderma gangraenosum (PG) in a 35-year-old woman is presented. Signs of both the ulcerative and vegetative forms of PG were expressed. The association of two systemic diseases, the autoimmune thyreopathy and the hyperandrogenic syndrome were observed in a female. The recommended conventional therapy for PG: corticosteroids, antibiotics, cyclosporine and cyclophosphamide yielded a poor response, whereas after thyroidectomy and reaching an euthyroid state the symptoms receded. This close association of PG and autoimmune thyreopathy supports the autoimmune concept of PG.

Adult↗

[Pyoderma gangrenosum in dakar: about 14 cases].

From January 1990 to December 2001, we undertook a retrospective study in the dermatology department of Aristide le Dantec hospital in order to assess the epidemiologic, clinical and evolutionary profiles of pyoderma gangrenosum (P.G). All files of patients diagnosed with PG were reviewed. The diagnosis was based on clinical and histological aspects. Fourteen files of patients with PG were reviewed. They were constituted of 8 males and 6 females, with a median age of 24.5 (extreme 4 and 54 years). Paediatric forms represented 30 % of the cases. The typical aspect with an ulceration with elevated edge comprising of purulent hutchs was observed in all the cases. The localization on the level of the lower limbs was noted among 12 patients (85.7 %). The PG was associated to chronic ulcerative colitis (1 case), rheumatoid spondylitis (1 case) and rheumatoid arthritis in all cases. After 11 weeks treatment by oral corticothérapy at the daily posology of 1 mg/kg/, cicatrization of cutaneous lesions were noted in all the cases. Five reccurences were observed. P.G remains a rare pathology with no difference on races and regions . this is particularly true on children. Our serie, is remarkable by the high frequency of its paediatric forms. As for clinical and evolutive aspects as well as associated pathologies, findings are comparable with those described other series

Adrenal Cortex Hormones↗

[Atypital localisation of pyoderma gangraenosum in patient with ulcerative colitis].

The authors present a case of 61-year-old man with ulcerative colitis and with extraintestinal manifestation of the disease in the form of pyoderma gangraenosum. Multiple skin defects, which developed in atypical localisation (extensive affection of facial and hairy parts of the head) in patient with chronically active form of ulcerative colitis were complicated with bacterial contamination of methicilin-resistant strains of Staphylococcus aureus. After application of the parenteral feeding, corticotherapy and targeted antibiotic therapy the subjective and objective status of the patient markedly improved, stool frequency was reduced, admixture of blood in the stool disappeared, temperatures fell back and there was a decrease in activity of non-specific bowel inflammation in laboratory findings. However endoscopic examination of the intestine confirmed the finding of chronically active ulcerative colitis with ulcerations and bridging polyps. Patient was indicated to total colectomy, but he refused it.

Colitis, Ulcerative↗

Pyoderma gangrenosum associated with ulcerative colitis.

We report the case of a 45-year old man with non-healing ulcers located on his chest, lumbal, sacral, retroauricular areas and forehead. Both clinical and histopathological examinations suggested pyoderma gangrenosum (PG). For six months the diagnosis of ulcerative colitis was established. PG in our patient was presented as a rapidly enlarging, painful ulcer with purple, undermined edges and a necrotic, haemorrhagic base. Initially, he was treated with a high dosage of peroral glucocorticosteroid, sulfasalazine, and systemic antibiotics, together with daily wound care. Ulceration partially regressed. Total colonoscopy showed pancolitis. When the dose of glucocorticosteroids was tapered down to 35 mg, new ulcerations on his right thigh and abdomen were formed. He also developed E. coli sepsis and flare up of bowel disease. Azathioprine, together with two pulse doses of glucocorticosteroids and antibiotics, were administered. He was scheduled for a total colectomy. The management of PG continues to be a therapeutic challenge.

Colitis, Ulcerative↗

Penile pyoderma gangrenosum.

We present a case of penile pyoderma gangrenosum (PG) that responded dramatically to an 8-week course of prednisone and has not recurred over a 6-month period. Although quite uncommon, penile PG should be a diagnostic consideration in any patient with non-healing ulcerative lesions of the penis. A correct diagnosis in this situation precludes unnecessary or harmful therapeutic interventions and leads to proper management.

Anti-Bacterial Agents↗

Pyoderma gangrenosum in a six-month-old boy.

Pyoderma gangrenosum (PG) is an uncommon, chronic ulcerative condition of the skin that was first described in 1930. It can occur in any age group, but only 4% of the patients are infants or children. An underlying systemic disease is present in approximately 50% of the patients with PG. The most common associations include inflammatory bowel disease, arthritis, lymphoproliferative disorders and chronic recurrent multifocal osteomyelitis (CRMO). PG has been reported in association with CRMO in only a few children whose ages were between 18 months and 12 years. We report a six-month-old boy who was diagnosed as CRMO based on his clinical examination and histological findings. This is the youngest case reported in the literature (under 12 months of age) with PG associated with CRMO.

Age of Onset↗

Pyoderma gangrenosum complicated with myelodysplastic syndrome followed by rapidly progressing pyothorax-associated lymphoma: a case report.

This report describes a patient with pyoderma gangrenosum (PG) complicated with myelodysplastic syndrome (MDS) followed by rapidly progressing pyothorax-associated lymphoma (PAL). A 74-year-old man was admitted with cutaneous gangrene associated with MDS. We diagnosed him as having PG, and high-dose oral prednisolone was started. Two months after admission he developed lymphoma rapidly. The patient died in spite of radiation therapy. On autopsy, the pathological diagnosis was diffuse large cell lymphoma. Epstein-Barr virus (EBV)-encoded RNA, and EBV-encoded nuclear antigen (EBNA) were detected in lymphoma cells. This case suggested that immunosuppressive therapy might favour the clonal proliferation of EBV-infected cells.

Aged↗

[Postoperative pyoderma gangrenosum and cancer of the breast. Apropos of a case].

Pyoderma gangrenosum (PG) consists of extensive necrotic ulceration with bluish and purplish red margins. This disease is often associated with ulcerative colitis, systemic, hematologic or rheumatic diseases. However post-surgical idiopathic PG can occur. One post-mastectomy case is reported. PG can first be suspected on clinical appearance and the lack of a specific etiology. PG is a diagnosis of exclusion that is made only after other possibilities have been ruled out. The treatment is surgical excision and systemic corticosteroids.

Adult↗

Successful treatment of myelodysplastic syndrome-induced pyoderma gangrenosum.

We report successful treatment of a refractory myelodysplastic syndrome-associated pyoderma gangrenosum with the combination of thalidomide and interferon-alpha2a in a single patient. A non-healing wound developed on a 40-year-old woman's left thumb after minor trauma. Massive ulcerovegetative lesions developed after reconstruction surgery. Histopathological examination of the bone marrow and cytogenetic studies revealed an atypical myeloproliferative/myelodysplastic syndrome. The skin lesions resolved dramatically after two months of thalidomide and interferon-alpha2a combination therapy and the haematological status improved.

Adult↗

Pyoderma gangrenosum in a renal transplant recipient: a case report.

Pyoderma gangrenosum (PG) is an ulcerative disease of the skin of unknown etiology. Its association with infection, autoimmune disease, inflammatory bowel disease, malignancy, and certain drugs suggests a hypersensitivity reaction. We herewith present a renal transplant recipient who developed PG. The patient presented with multiple necrotizing skin ulcers on both the upper and lower extremities associated with malaise, myalgia, arthralgia, weight loss and low-grade fever. To our knowledge, the association between PG and renal transplant has not been reported previously.

Adrenal Cortex Hormones↗

[Pyoderma gangrenosum and Crohn's disease].

A careful survey of the literature on the relationships between pyoderma gangrenosum and Crohn disease is made. The pathogenetical and clinical aspects are analysed and a case, personally observed, is presented.

Adrenal Cortex Hormones↗

Pyoderma gangrenosum in Papua New Guinea.

A severe case of pyoderma gangrenosum in a Papua New Guinean girl aged 11 years in reported. Multiple lesions of the arms, legs, buttocks and mouth were present. There was no associated disease. She was treated with very high doses of prednisolone and slow resolution over 3 months in hospital was observed.

Acute Disease↗

Pyoderma gangrenosum complicating Felty's syndrome.

The case of a 54-year-old woman with Felty's syndrome whose course was complicated by mucocutaneous lesions clinically typical of pyoderma gangrenosum is described. Necrotizing sinusitis and saddle nose deformity were distinctive clinical features. Lymphocytic vasculitis and rheumatoid nodule formation observed within panniculus at the base of a cutaneous lesion and in a nasal mucosal lesion were unexpected histopathologic findings.

Felty Syndrome↗

[The morphofunctional characteristics of the peripheral lymph nodes in patients with chronic pyoderma].

Pathohistologic examinations of the peripheral lymph nodes in 14 patients with abscessed acne, chronic infiltrative ulcerous and infiltrative fistulous pyoderma coursing for 1 to 11 years have revealed that chronic pyococcal infection induces manifest atrophic and sclerotic changes in the cortical and medullary layers of the regional lymph nodes and of those distant from foci of involvement; these changes are accompanied by essential impairments of the immunologic, lymphopoietic, and other functions.

Abscess↗

Evaluation of a commercial staphylococcal bacterin for management of idiopathic recurrent superficial pyoderma in dogs.

Twenty-one dogs with idiopathic superficial recurrent pyoderma were entered into a double-blind, placebo-controlled study to evaluate the efficacy of a commercial staphylococcal bacterin. The study spanned an 18-week period. All dogs were administered sodium oxacillin orally for the initial 6 weeks of the study. Dogs were given the bacterin or placebo SC, twice weekly at 3- or 4-day intervals, beginning at week 0 and continuing for 18 weeks. Dogs given antibiotics plus the bacterin (n = 13) had a significantly (P less than 0.05) better treatment response than those given antibiotic plus placebo.

Animals↗

[Pyoderma gangrenosum and IgA gammopathy. Association with atrophic gastritis].

Pyoderma gangrenosum (PG) is a rare condition remarkable for its association with particular diseases, notably haemopathies and gastrointestinal diseases. As regards haemopathies, the associations most frequently encountered are with myeloid malignancies and monoclonal dysglobulinaemia. The association of PG with mainly inflammatory digestive tract diseases is also classical. The lack of publications concerning gastric atrophy and the dual haematological and gastric pathology which characterizes our case have prompted us to report it. A 60-year-old woman without significant history was admitted for PG on both knees, following vesiculo-bullous lesions. Laboratory examinations detected a normochromic anaemia tending to be macrocytic, a marked inflammatory syndrome and a monoclonal lambda light chain IgA peak at protein immunoelectrophoresis. Bone marrow biopsy, skeletal radiography and a search for Bence-Jones proteinuria were normal or negative. Colonoscopy showed no abnormality, but fibroscopy of the upper digestive tract revealed a severe gastric atrophy en plaques. Serum vitamin B12 level was moderately low, but there was no other sign of pernicious anaemia. After one month treatment with systemic corticosteroids, healing was obtained under replacement vitamin therapy. PG recurred a few months later; serum vitamin B12 level was normal, and the lesions healed after systemic corticosteroid treatment. In non-myelomatous dysglobulinaemia IgA is frequently found and there is no light chain predominance. PG often precedes dysglobulinaemia. Evolution towards a true myeloma seems to be exceptional. In a recent publication, 17 cases of association between PG and myeloma were mentioned, the IgA type being most common. Protein electrophoresis is indispensable in patients with PG. Five cases of congenital hypogammaglobulinaemia have been recorded, including three with IgA deficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

Agammaglobulinemia↗