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PubMed1989

[Structuro-functional properties of staphylococci in patients with pyoderma].

Electron-microscopic and ultra-cytochemical studies have shown the structural and functional features of pyoderma agents--staphylococci isolated from patients with acute and chronic pyoderma. The studies have revealed magnesium-activated ATPase and adenylate cyclase in these bacteria; the authors have tried to trace a correlation between these enzymes' activities and location and the disease pattern. This may help assess the bacterial population status and choose the drugs for purposeful pathogenetic therapy.

Adenylyl Cyclases↗
PubMed1989

[Carbohydrate metabolism in patients with chronic pyoderma and its dynamics during therapy using sugar-decreasing preparations].

Carbohydrate metabolism has been examined in 301 patients with chronic pyoderma over the course of combined therapy including sugar-reducing drugs; biochemical methods (measurement of the blood sugar on an empty stomach, Staub-Traugott double carbohydrate load test, measurement of the blood serum seromucoid) and radioimmunoassay of the blood serum immunoreactive insulin have been employed. Diabetes mellitus has been first diagnosed in 2.9% of patients, latent diabetes in 18.8%, and in 4.7% of the examinees the parameters indicate the risk of this condition development. Combined therapy improves the examined parameters, providing good immediate and late results. These data favor the use of sugar-reducing agents in multiple-modality therapy of patients with chronic pyoderma.

Adult↗
PubMed1989

[Experience in using a tomicide paste in the combined treatment of patients with pyoderma].

Tomicide paste is a highly effective agent in combined therapy of patients with primary and secondary pyoderma. Tomicide is recommended for practical dermatology in the liquid form for sanitization++ of infection foci in nasopharyngeal organs and in paste with a 10% concentration of the agent. This paste is also advised for cases with secondary pyoderma complicating the course of neurodermatitis and chronic eczema not liable to weeping.

Animals↗
PubMed1989

[Gangrenous pyoderma. A review].

Pyoderma gangrenosum is a distinctive, uncommon, ulcerative condition with an associated systemic disease in most cases. The causative mechanism of this disease is still unknown. In this article, we review the pathogenesis of pyoderma gangrenosum, its clinicopathologic picture and the currently available therapeutic alternatives. Associations with systemic disease are also reviewed.

Gangrene↗
PubMed1989

Pyoderma gangrenosum.

Pyoderma gangrenosum is an uncommon skin disorder often associated with systemic disease, especially chronic ulcerative colitis (Figures 1, 2, and 3). Therapy is twofold--local care and control of the underlying illness. While the overall prognosis is good and the disease is rarely fatal, pyoderma gangrenosum is physically and mentally crippling with a propensity for recurrence.

Aged↗
PubMed1989

The epidemiology of pyoderma in Jamaican children.

Preschool and school-aged children from a small area of rural Jamaica were examined in an attempt to assess the epidemiologic factors predisposing certain persons to pyoderma. Twenty-three children were included in the affected group; their disease consisted of secondarily infected insect bites or infestations as well as primary pyoderma. The control group was composed of twenty-three children who had no evidence of infected skin disease. Comparison of the two groups revealed a significant difference in the socioeconomic status of the control and study groups. There was no statistically significant difference in nutritional status, size of family, bathing frequency, or water supply.

Age Factors↗
PubMed1986

Pyoderma gangrenosum involving the head and neck.

In six patients with pyoderma gangrenosum, the head and neck region was a major site of ulcerative skin disease. In two patients, the disease was limited to this anatomic site. Corticosteroids were effective therapy in five cases. In one case, occurring in association with ulcerative colitis, total proctocolectomy was required to control ulcerative scalp disease. Detailed histologic examination of a primary lesion in one case with 0.5-micron sections demonstrated morphologic evidence of mast cell activation, suggesting that mast cells may contribute to the pathogenesis of the inflammatory process in pyoderma gangrenosum.

Adrenal Cortex Hormones↗
PubMed1987

Pyoderma gangrenosum associated with ulcerative colitis: treatment with disodium cromoglycate.

Pyoderma gangrenosum is an uncommon skin disorder that is associated with ulcerative colitis, Crohn's disease, polyarthritis, and other conditions. Clinically it is usually characterized by painful ulceration of the skin and subcutaneous tissues, predominantly of the lower limbs. Treatment is empirical and often unsatisfactory. We report two cases of pyoderma gangrenosum associated with inflammatory bowel disease successfully treated with topical disodium cromoglycate.

Administration, Topical↗
PubMed1988

A case of malignant pyoderma with neurological manifestations.

A case of malignant pyoderma with a fatal course is presented. A 62-year-old Chinese man was admitted with a 8-month history of progressive ulcerative nodular skin lesions starting on the right antecubital fossa and spreading to the chest, face, arms and legs. The lesions failed to respond to many antibiotics. Examination revealed multiple large crusted foul-smelling ulcers with erythematous raised vegetative edges and tender erythematous nodules. Investigations showed an anaemia of chronic disease and an erythrocyte sedimentation rate of 135mm/1st hour. Histology showed multiple circumscribed microabscesses in the upper dermis. The skin lesions responded well to systemic corticosteroid therapy. Three months after admission, he developed multiple cranial nerve palsies, and severe progressive peripheral neuropathy. Radiographic studies revealed cavitating lesion in the right upper lobe consistent with a diagnosis of carcinoma of the lung. Five months after admission, patient was intubated for stridor but he succumbed to aspiration pneumonia. Malignant pyoderma should be considered if an ulcer fails to respond to antibiotics, and possible neurological complications should be thought of.

Anti-Bacterial Agents↗
PubMed1988

[Pyoderma gangrenosum: treatment with plasma exchange (4 cases)].

Four patients with pyoderma gangrenosum were treated by plasma exchange. The series included one woman (cervical localization) and three men (sural localization in 1 case, multiple trunk and facial localizations in the second case and multiple, recurrent localizations on trunk and limbs in the third case). In 2 cases another disease was associated (ulcerative colitis in 1 case and Crohn's disease in the other). Between 6 and 12 plasma exchange sessions were carried out in combination with corticotherapy (1/2 mg/kg/day). Results in 2 cases were rated as very good: progression of the disease interrupted and no further pain after the 1st plasma exchange, rapid healing of lesions (a skin graft was necessary for a lesion of hand exposing tendons). A good result was obtained in the 3rd case with interruption of progression of lesions after the 1st plasma exchange but slower relief of pain. Treatment was considered a failure in the 4th case since there was no obvious regression in lesions or pain. Three of the 4 patients had no recurrences, one patient developing recurrences on 4 occasions responding well to plasma exchange each time. Pyoderma gangrenosum is a good indication for use of plasma exchange, which limits extension of ulcerating lesions, suppresses or reduces pain and decreases esthetic prejudice.

Adolescent↗
PubMed1987

[Peristomal pyoderma gangrenosum in a patient with ulcero-hemorrhagic rectocolitis].

Cutaneous manifestations of chronic ulcerative colitis are numerous and present in 20 p. 100 of the patients. The case of a 49-year old man with peristomal pyoderma gangrenosum (PG) is presented. In November, 1983, one year after the onset of chronic ulcerative colitis, the patient underwent total colectomy. The formation of an ileal reservoir resulted in a pelvic abscess which necessitated right lower ileostomy. Because of severe ulcerations around the stoma, the ileostomy was transferred to the left lower abdomen. Similar inflammatory ulcerations developed, and the diagnosis of pyoderma gangrenosum was made. The patient responded very well to dapsone combined with prednisone for only 6 months. The possibility of PG being an autoimmune condition is discussed, as well as the differential diagnosis. The several therapeutic approaches are summarized. The peristomal localization of PG in this patient suffering from chronic ulcerative colitis seems to be rather unique. No other case has been reported so far, to our knowledge.

Administration, Topical↗
PubMed1987

[Pyoderma gangrenosum and pelvispondylitis without patent intestinal disease. Apropos of a case].

The authors report a case of pyoderma gangrenosum associated with a positive B27 pelvispondylitis. The search for a hemorrhagic rectocolitis, possible link between the two syndromes, revealed to be negative. Pelvispondylitis is an unusual complication of pyoderma gangrenosum. Review of the literature shows only one case of sacroiliitis, beside seronegative polyarthritis unrelated to HLA B27.

Adult↗
PubMed1987

Pyoderma gangrenosum: skin grafting after preparation with hyperbaric oxygen.

Four patients with pyoderma gangrenosum were treated with hyperbaric oxygen to prepare the wounds for skin grafting. Each wound responded to a course of daily hyperbaric oxygen with reduction of infection and increased capillary angiogenesis. During follow-up periods of 12 to 30 months, all wounds remained healed. Although the exact etiology of pyoderma gangrenosum is unknown, vasculitis with wound ischemia and infection are prominent components. Inspired oxygen partial pressures of 1100 to 1300 mmHg elevate wound oxygen tension despite relative ischemia. The impaired intracellular bacterial killing of hypoxic leukocytes is corrected during each day's 2-hour bolus of hyperbaric oxygen. Daily wound oxygenation increases collagen production by fibroblasts to support capillary angiogenesis.

Adolescent↗
PubMed1987

Pyoderma gangrenosum in a kindred. Precipitation by surgery or mild physical trauma.

Five cases of pyoderma gangrenosum occurring in a kindred are presented. Three of the cases occurred after abdominal surgery and tended to be confused with postoperative wound infections. Two cases occurred after superficial injury to the leg and were also thought to represent a peculiar form of cellulitis. None of the patients are known to have any of the underlying diseases usually associated with pyoderma gangrenosum. The cases are presented to alert the physician to this entity and to document the unusual familial occurrence.

Abdomen↗
PubMed1987

[Pyoderma gangrenosum. 14 personal observations and review of the literature].

Fourteen cases of pyoderma gangrenosum are reported. Twelve were associated with various diseases: ulcerative colitis, Crohn disease, colic tumor, rheumatoid arthritis, chronic myeloid leukemia, agammaglobulinemia, respiratory infections (2 cases) and post surgical intervention. In 2 cases pyoderma gangrenosum appeared to be primary. The clinical characteristics of the affection make it a very particular type of ulcer: pustular onset, frequent localization to other than leg, rapid eccentric spread, frequent associated morbidity (mainly digestive and hematologic). The pathogenesis is still unknown and the treatment is not well codified.

Adolescent↗
PubMed1987

[Postoperative pyoderma gangrenosum. Apropos of 2 cases].

The typical lesion of pyoderma gangrenosum is a rapidly extending necrotic ulceration, often associated with a system affection, inflammatory colitis, hematologic affections, rheumatic disorders. In about 30% of cases it develops on the site of a sometimes minimal injury. In the two cases reported one developed in the region of a graft after excision of a basal cell epithelioma, the other in a peritoneal drainage scar after colon resection. In patients with pyoderma gangrenosum, initial discussion must involve possible causes of the cutaneous necrosis, but in the cases reported the clinical appearance and rapid progression of the lesion, and negative results of serial bacteriologic and mycologic examinations were in favor of this diagnosis. An accurate diagnosis is essential since general corticotherapy is usually necessary.

Adrenal Cortex Hormones↗