Background And Aim: dermatological manifestations are normally found in one third of patients with inflammatory bowel disease. In this study, the prevalence, clinical characteristics, intestinal disease activity, and treatment response of neutrophilic dermatoses (pyoderma gangrenosum and Sweet´s syndrome) were determined in patients with inflammatory bowel disease.
Methods: a retrospective, observational study was performed in patients with inflammatory bowel disease and neutrophilic dermatoses between March 2012 and March 2018.
Results: of 444 patients analyzed, 10 complied with the inclusion criteria. Seven had pyoderma gangrenosum and three presented Sweet's syndrome; and one patient developed both pathologies. The prevalence of neutrophilic dermatoses was 2.3 % (10/444), comprising 1.6 % with pyoderma gangrenosum and 0.7 % with Sweet's syndrome. Six out of seven patients with pyoderma gangrenosum were female and had ulcerative colitis. The most frequent clinical presentation of pyoderma gangrenosum was the ulcerative subtype. Active moderate-to-severe intestinal disease was found in 71.4 % of patients. Biological therapy was prescribed to three patients with partial response to corticosteroids and persistent intestinal disease activity. This therapy was not indicated for cutaneous manifestations only. Three patients with moderate-to-severe Crohn´s disease presented classical (n = 2) and pustular (n = 1) Sweet's syndrome. A complete response was achieved in all Sweet's syndrome cases treated with corticosteroids. Biological therapy was prescribed to control intestinal disease activity.
Conclusions: pyoderma gangrenosum was the most frequent cutaneous manifestation of neutrophilic dermatoses, predominantly in females with ulcerative colitis, and highly associated with intestinal disease activity. Anti-tumor necrosis factor was effective in patients with partial cutaneous and intestinal disease response.
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http://dx.doi.org/10.17235/reed.2020.7431/2020 | DOI Listing |
Adv Skin Wound Care
January 2025
Arbie Sofia P. Merilleno, MD, DPDS, is an Inflammatory Disease Fellow, University of Toronto, Ontario, Canada; Clinical Fellow, Women's College Hospital, Ontario; and Research Fellow, Women's College Research Institute, Ontario. Charlene Marie Ang-Tiu, MD, FPDS, is Medical Specialist, Rizal Medical Center, Pasig City, Philippines.
Pyoderma gangrenosum is a rare ulcerative condition that poses diagnostic and therapeutic challenges. Diagnosis and appropriate management are often delayed due to its rarity and the presence of numerous clinical variants. In this case report, the authors present the case of a 36-year-old man who had long-standing and nonhealing ulcers that did not respond to multiple antibiotics and serial wound debridement.
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Dermatology Department, Cliniques universitaires Saint-Luc, Brussels, Belgium
We describe a man in his 60s presenting poor scar development following surgical treatment for popliteal aneurysm. The clinical features in a postoperative context and the poor clinical response to intravenous broad-spectrum antibiotics were highly suggestive of bullous pyoderma gangrenosum. Histology, with dense inflammatory infiltrate of neutrophils, subsequently confirmed the diagnosis and the response to systemic corticosteroids was rapid and complete.
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December 2024
Department of Internal Medicine, Trofa Saúde Hospital Privado em Gaia, Vila Nova de Gaia, Portugal.
Autoinflammatory bone disorders (ABDs) are characterized by sterile bone inflammation stemming from dysregulated innate immune responses. This review focuses on the occurrence of sterile osteomyelitis in ABDs and related diseases, notably chronic nonbacterial osteomyelitis (CNO) and its sporadic and monogenic forms, such as deficiency of the interleukin-1 (IL-1) receptor antagonist, Majeed syndrome, CNO related to mutation, and pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA syndrome). Additionally, other autoinflammatory disorders (AIDs) are discussed, including classical periodic fever syndromes (e.
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January 2025
Department of Dermatology, Hospital de Câncer de Barretos, Barretos, SP, Brazil; Department of Dermatology, Faculdade de Ciências da Saúde de Barretos Dr. Paulo Prata, Barretos, SP, Brazil.
An Bras Dermatol
January 2025
Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil. Electronic address:
Ischemic ulcers due to compromised microcirculation of the lower limbs cause painful ulcers that pose a challenge for the correct diagnosis and treatment. Livedoid vasculopathy, calciphylaxis, and Martorell's hypertensive ischemic ulcer are part of this group and present some similarities due to microvascular occlusive impairment. They are often misdiagnosed as inflammatory ulcers such as pyoderma gangrenosum and vasculitis.
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