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A Case of Recurrent Idiopathic Pyoderma Gangrenosum

Pyoderma gangrenosum (PG) is a rare chronic neutrophilic dermatosis that can be associated with underlying conditions, such as inflammatory bowel disease and neoplasms, or can be idiopathic. Classically, it presents as painful skin lesions. We present a case of a 54-year-old woman who got a synovial...

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Autores principales: David, Filipa, Lopes Freitas, Rafaela, Brás-Cruz, Rute, Rocha, Joana, Rosário, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205452/
https://www.ncbi.nlm.nih.gov/pubmed/35733460
http://dx.doi.org/10.7759/cureus.25112
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author David, Filipa
Lopes Freitas, Rafaela
Brás-Cruz, Rute
Rocha, Joana
Rosário, Cristina
author_facet David, Filipa
Lopes Freitas, Rafaela
Brás-Cruz, Rute
Rocha, Joana
Rosário, Cristina
author_sort David, Filipa
collection PubMed
description Pyoderma gangrenosum (PG) is a rare chronic neutrophilic dermatosis that can be associated with underlying conditions, such as inflammatory bowel disease and neoplasms, or can be idiopathic. Classically, it presents as painful skin lesions. We present a case of a 54-year-old woman who got a synovial cyst removed from her left hand, which later aggravated into a non-healing wound, and subsequently a painful necrotic ulcer. The histological pattern combined with the clinical features suggested PG. General wound care was performed, associated with topical tacrolimus and oral corticotherapy with a good response. Three similar episodes with lesions scattered over the body followed and required a combination of other pharmacological alternatives. An extensive etiological study was carried out to screen secondary causes without any relevant findings. Therefore, an idiopathic relapsing PG was assumed. PG is poorly understood, underdiagnosed and hard to treat. It has a clear impact on the quality of life of the patient, so high suspicion and timely treatment are essential to minimize complications.
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spelling pubmed-92054522022-06-21 A Case of Recurrent Idiopathic Pyoderma Gangrenosum David, Filipa Lopes Freitas, Rafaela Brás-Cruz, Rute Rocha, Joana Rosário, Cristina Cureus Dermatology Pyoderma gangrenosum (PG) is a rare chronic neutrophilic dermatosis that can be associated with underlying conditions, such as inflammatory bowel disease and neoplasms, or can be idiopathic. Classically, it presents as painful skin lesions. We present a case of a 54-year-old woman who got a synovial cyst removed from her left hand, which later aggravated into a non-healing wound, and subsequently a painful necrotic ulcer. The histological pattern combined with the clinical features suggested PG. General wound care was performed, associated with topical tacrolimus and oral corticotherapy with a good response. Three similar episodes with lesions scattered over the body followed and required a combination of other pharmacological alternatives. An extensive etiological study was carried out to screen secondary causes without any relevant findings. Therefore, an idiopathic relapsing PG was assumed. PG is poorly understood, underdiagnosed and hard to treat. It has a clear impact on the quality of life of the patient, so high suspicion and timely treatment are essential to minimize complications. Cureus 2022-05-18 /pmc/articles/PMC9205452/ /pubmed/35733460 http://dx.doi.org/10.7759/cureus.25112 Text en Copyright © 2022, David et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Dermatology
David, Filipa
Lopes Freitas, Rafaela
Brás-Cruz, Rute
Rocha, Joana
Rosário, Cristina
A Case of Recurrent Idiopathic Pyoderma Gangrenosum
title A Case of Recurrent Idiopathic Pyoderma Gangrenosum
title_full A Case of Recurrent Idiopathic Pyoderma Gangrenosum
title_fullStr A Case of Recurrent Idiopathic Pyoderma Gangrenosum
title_full_unstemmed A Case of Recurrent Idiopathic Pyoderma Gangrenosum
title_short A Case of Recurrent Idiopathic Pyoderma Gangrenosum
title_sort case of recurrent idiopathic pyoderma gangrenosum
topic Dermatology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205452/
https://www.ncbi.nlm.nih.gov/pubmed/35733460
http://dx.doi.org/10.7759/cureus.25112
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