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Idiopathic recurrent pyoderma gangrenosum with cobalamin deficiency in a 62-year-old male: a case report

Pyoderma gangrenosum (PG) is a rare, neither infectious nor gangrenous, neutrophil-mediated inflammatory dermatosis. In 50–70% of cases, systemic disease is the underlying cause, and the remaining is idiopathic. CASE PRESENTATION: The authors here present a case of a 62-year-old male with a history...

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Autores principales: Sitaula, Seema, Kharel, Sanjeev, Sherpali, Aakash, Shrees, Vijay, Mainali, Atul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010805/
https://www.ncbi.nlm.nih.gov/pubmed/36923778
http://dx.doi.org/10.1097/MS9.0000000000000253
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author Sitaula, Seema
Kharel, Sanjeev
Sherpali, Aakash
Shrees, Vijay
Mainali, Atul
author_facet Sitaula, Seema
Kharel, Sanjeev
Sherpali, Aakash
Shrees, Vijay
Mainali, Atul
author_sort Sitaula, Seema
collection PubMed
description Pyoderma gangrenosum (PG) is a rare, neither infectious nor gangrenous, neutrophil-mediated inflammatory dermatosis. In 50–70% of cases, systemic disease is the underlying cause, and the remaining is idiopathic. CASE PRESENTATION: The authors here present a case of a 62-year-old male with a history of recurrent ulcer over the dorsum of hand diagnosed with recurrent PG with cobalamin deficiency treated with intralesional steroid injection and topical antibiotics along with intramuscular vitamin B12 injections. The patient returned after a year with a history of swelling in the left hand for 1 week, which was managed with intravenous antibiotics. CLINICAL DISCUSSION: The most common kind of PG is ulcerative, which accounts for around 85% of cases that have been found. Ulcerative PG begins as small, painful erythematous or violaceous papules and pustules that quickly develop into ulcers with an exudative, mucopurulent, hemorrhagic base or with areas of necrosis and high, well-defined, serpiginous, violet-blue, or metallic grey borders, which are its defining feature. Glucocorticoids, along with a wide range of additional systemic immunomodulatory medication as alternatives and antibiotics to prevent infection are used for treatment. CONCLUSION: PG is a rare form of neutrophilic dermatosis that can be difficult to diagnose and treat. PG has a mixed nutritional deficiency and a history of ulcers. It is crucial to have a high degree of suspicion when making a diagnosis, as well as to look for associated diseases and start treatment as soon as possible.
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spelling pubmed-100108052023-03-14 Idiopathic recurrent pyoderma gangrenosum with cobalamin deficiency in a 62-year-old male: a case report Sitaula, Seema Kharel, Sanjeev Sherpali, Aakash Shrees, Vijay Mainali, Atul Ann Med Surg (Lond) Case Reports Pyoderma gangrenosum (PG) is a rare, neither infectious nor gangrenous, neutrophil-mediated inflammatory dermatosis. In 50–70% of cases, systemic disease is the underlying cause, and the remaining is idiopathic. CASE PRESENTATION: The authors here present a case of a 62-year-old male with a history of recurrent ulcer over the dorsum of hand diagnosed with recurrent PG with cobalamin deficiency treated with intralesional steroid injection and topical antibiotics along with intramuscular vitamin B12 injections. The patient returned after a year with a history of swelling in the left hand for 1 week, which was managed with intravenous antibiotics. CLINICAL DISCUSSION: The most common kind of PG is ulcerative, which accounts for around 85% of cases that have been found. Ulcerative PG begins as small, painful erythematous or violaceous papules and pustules that quickly develop into ulcers with an exudative, mucopurulent, hemorrhagic base or with areas of necrosis and high, well-defined, serpiginous, violet-blue, or metallic grey borders, which are its defining feature. Glucocorticoids, along with a wide range of additional systemic immunomodulatory medication as alternatives and antibiotics to prevent infection are used for treatment. CONCLUSION: PG is a rare form of neutrophilic dermatosis that can be difficult to diagnose and treat. PG has a mixed nutritional deficiency and a history of ulcers. It is crucial to have a high degree of suspicion when making a diagnosis, as well as to look for associated diseases and start treatment as soon as possible. Lippincott Williams & Wilkins 2023-02-17 /pmc/articles/PMC10010805/ /pubmed/36923778 http://dx.doi.org/10.1097/MS9.0000000000000253 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Case Reports
Sitaula, Seema
Kharel, Sanjeev
Sherpali, Aakash
Shrees, Vijay
Mainali, Atul
Idiopathic recurrent pyoderma gangrenosum with cobalamin deficiency in a 62-year-old male: a case report
title Idiopathic recurrent pyoderma gangrenosum with cobalamin deficiency in a 62-year-old male: a case report
title_full Idiopathic recurrent pyoderma gangrenosum with cobalamin deficiency in a 62-year-old male: a case report
title_fullStr Idiopathic recurrent pyoderma gangrenosum with cobalamin deficiency in a 62-year-old male: a case report
title_full_unstemmed Idiopathic recurrent pyoderma gangrenosum with cobalamin deficiency in a 62-year-old male: a case report
title_short Idiopathic recurrent pyoderma gangrenosum with cobalamin deficiency in a 62-year-old male: a case report
title_sort idiopathic recurrent pyoderma gangrenosum with cobalamin deficiency in a 62-year-old male: a case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010805/
https://www.ncbi.nlm.nih.gov/pubmed/36923778
http://dx.doi.org/10.1097/MS9.0000000000000253
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