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Giornale Italiano di Dermatologia e Venereologia 1999 October;134(5):485-8

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: Italian

Pyoderma gangrenosum. Report of a case associated with ulcerative colitis in an adolescent

Pestelli E., Battini M. L., Caproni M., Fabbri P.

Università degli Studi - Firenze, Istituto di Clinica Dermatologica II


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Pyoderma gangrenosum (PG) is an uncommon mucous-cutaneous disease with a chronic course characterized by ulcerative inflammatory lesions. The disease develops in most patients between the ages of 25 and 54 years. It can occur in childhood, in 4% of cases, usually in association with a systemic disease such as inflammatory bowel disease (50% of cases) immunodeficiency or immunosuppression. PG has four distinctive clinical and histological variants. Pathergy (the development of lesions at sites of minor trauma) which occurs in 20% of patients with this disorder may be more common in childhood. The diagnosis of PG depends on the recognition of the evolving clinical features because histopathologic changes are not specific and there are no characteristic serologic or hematologic markers of the disease. The case of a 14-year-old girl with PG in a typical ulcerative variant associated with ulcerative colitis is reported. Clinical manifestations were characterized by the appearance of nodular lesions with blue, undermined borders evolving in necrotic ulcers. She had very serious dermatologic and bowel manifestations in which the therapy with steroid and cyclisporine was ineffective and for this reason total proctocolectomy was necessary.

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