Pyoderma gangrenosum and rheumatoid arthritis with massive necrotic ulcer of the right foot.
Pyoderma gangrenosum (PG) is associated with systemic disease, mostly rheumatoid arthritis (RA) and inflammatory bowel disease (IBD), in many patients (more than 50%). Lesions associated with arthritis are often ulcerative. Although these lesions typically affect the lower limbs, they can also affec...
| Publicado en: | Wounds: A Compendium of Clinical Research & Practice Vol. 21; no. 2; pp. 37 - 42 |
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| Autores principales: | , , |
| Formato: | case study diagnostic images pictorial Journal Article |
| Publicado: |
HMP Global
2009 Feb
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105489414&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105489414 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10447946 YZM jtl: Wounds: A Compendium of Clinical Research & Practice issn: 10447946 maglogo: N pubinfo: dt: 2009 Feb vid: 21 iid: 2 pid: 20465 pub: HMP Global place: Malvern, Pennsylvania artinfo: ui: 105489414 105489414 2010236450 105489414 ppf: 37 ppct: 5 formats: tig: atl: Pyoderma gangrenosum and rheumatoid arthritis with massive necrotic ulcer of the right foot. aug: au: Pacifico F Di Giacomo A Vergineo PP affil: Ospedale Sacro Cuore di Gesù-Fatebenefratelli Viale Principe di Napoli 14/A 82100 Benevento Italy; fabiopacifico@libero.it sug: subj: Arthritis, Rheumatoid Foot Ulcer Pyoderma Gangrenosum Aged Diagnosis, Laboratory Foot Radiography Italy Male Necrosis Prednisolone Administration and Dosage Pyoderma Gangrenosum Diagnosis Pyoderma Gangrenosum Drug Therapy Wound Healing Aged: 65+ years Male ab: Pyoderma gangrenosum (PG) is associated with systemic disease, mostly rheumatoid arthritis (RA) and inflammatory bowel disease (IBD), in many patients (more than 50%). Lesions associated with arthritis are often ulcerative. Although these lesions typically affect the lower limbs, they can also affect the entire body. Successful therapy involving monoclonal antibodies seems to favor an autoimmune etiopathogenesis that has disorders of neutrophils' chemotactic activity and interleukins, which are acted upon by TNF-alpha cytokines. The ulcers grow rapidly, exacerbate after trauma, and necrosis can invade each skin layer up to the fascia. Therefore, debridement is contraindicated because it introduces the so-called 'pathergy' mechanism. The diagnosis is quite difficult and is often made late due to the lack of indicative clinical and laboratory findings. The following is a report of a case of multiple, ulcerative, PG ulcers induced by arthritis. The ulcers occurred over several occasions with large and aggressive necrosis reaching the osseous plane in the heel and elbow. The high IgE values (between 2000 UI/mL and 3000 UI/mL) suggested that a type I immunitary reaction, such as in-skin anaphylaxis, was involved. Nevertheless, the antigen remains unknown and the genesis may be multifactorial. A corticosteroid (prednisolone) was the first-line systemic treatment used in this case and caused rapid improvement. Further investigations will be necessary to understand the meaning of this immunologic disorder. pubtype: Periodical doctype: case study diagnostic images pictorial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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