Pyoderma gangrenosum in refractory celiac disease: a case report.

Background: Pyoderma gangrenosum is an inflammatory neutrophilic dermatosis characterized by painful cutaneous ulcerations and often associated with systemic inflammatory and neoplastic diseases. Here we report the first case of pyoderma gangrenosum in a patient with refractory celiac disease.Case P...

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Published in:BMC Gastroenterology Vol. 13; no. 1; pp. 162 - 163
Main Authors: Sedda, Silvia, Caruso, Roberta, Marafini, Irene, Campione, Elena, Orlandi, Augusto, Pallone, Francesco, Monteleone, Giovanni
Format: case study Journal Article
Published: BioMed Central 2013
Online Access:View this record in EBSCOhost
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        10.1186/1471-230X-13-162
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        atl: Pyoderma gangrenosum in refractory celiac disease: a case report.
      aug:
        au:
          Sedda, Silvia
          Caruso, Roberta
          Marafini, Irene
          Campione, Elena
          Orlandi, Augusto
          Pallone, Francesco
          Monteleone, Giovanni
        affil: Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 1, 00133 Rome, Italy. Gi.Monteleone@Med.uniroma2.it.
      sug:
        subj:
          Celiac Disease Complications
          Pyoderma Gangrenosum Complications
          Female
          Middle Age
          Middle Aged: 45-64 years
          Female
      ab: Background: Pyoderma gangrenosum is an inflammatory neutrophilic dermatosis characterized by painful cutaneous ulcerations and often associated with systemic inflammatory and neoplastic diseases. Here we report the first case of pyoderma gangrenosum in a patient with refractory celiac disease.Case Presentation: A 52-year-old woman with a previously diagnosed refractory celiac disease resistant to steroids and immunosuppressive drugs presented to our hospital for a rapidly growing, painful inflammatory skin lesion of the left leg. Physical examination revealed a painful lesion with focal ulceration, necrosis and pus discharge with active inflammatory borders at the external part of the left leg. Histological evaluation of a skin biopsy and analysis of inflammatory cytokines and matrix-degrading proteases in lesional skin samples confirmed the clinical suspicion of pyoderma gangrenosum. Treatment with oral prednisone was rapidly followed by a complete healing of the skin lesion but no improvement of symptoms/signs of malabsorption.Conclusion: Treatment of the patient with systemic steroids healed the skin lesion without improving the underlying refractory celiac disease. This observation raises the possibility that refractory celiac disease and pyoderma gangrenosum may be immunologically different.
      pubtype: Academic Journal
      doctype:
        case study
        Journal Article
      ougenre: Article
    language: English
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