A case of pyoderma gangrenosum induced by insulin.
Pyoderma gangrenosum (PG) is a rare auto‐inflammatory, neutrophilic, ulcerative disorder characterised by acutely painful, rapidly spreading, sterile ulcers over the trunk and lower limbs. The pathogenic mechansim of PG is under constant evolution and drugs are emerging to be a an important trigger....
| Publicado en: | International Wound Journal Vol. 16; no. 5; pp. 1239 - 1243 |
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| Autores principales: | , , , , |
| Formato: | case study pictorial Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2019
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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=139102150&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139102150 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17424801 1725 jtl: International Wound Journal issn: 17424801 maglogo: Y pubinfo: dt: Oct2019 vid: 16 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 139102150 139102150 139102150 10.1111/iwj.13170 139102150 ppf: 1239 ppct: 4 formats: tig: atl: A case of pyoderma gangrenosum induced by insulin. aug: au: Noronha, Malcom Arora, Sukriti Pai, Kantilatha Sathish Pai, B. Jindal, Anuradha affil: Department of dermatology, venereology and leprosy, Kasturba Medical college, Manipal Academy of Higher Education, Manipal India sug: subj: Insulin Adverse Effects Pyoderma Gangrenosum Chemically Induced Drug Toxicity Diagnosis Pyoderma Gangrenosum Diagnosis Male Middle Age Ulcer Injections, Subcutaneous Insulin Administration and Dosage Hyperplasia Epidermis Neutrophils Dermis Algorithms Matrix Metalloproteinases Therapeutic Use Peptide Hydrolases Therapeutic Use Middle Aged: 45-64 years Male ab: Pyoderma gangrenosum (PG) is a rare auto‐inflammatory, neutrophilic, ulcerative disorder characterised by acutely painful, rapidly spreading, sterile ulcers over the trunk and lower limbs. The pathogenic mechansim of PG is under constant evolution and drugs are emerging to be a an important trigger. In the literature, 52 cases of drug‐induced PG have been documented, of which cocaine laced with levamisole has shown most direct association, with a mean Naranjo score of 9. Other drugs probably associated with PG are isotretinoin, sunitinib, and propylthiouracil. We describe a case of a 59‐year‐old male who had multiple well‐defined ulcers with a violaceous, undermined edge limited to the site of subcutaneous injection of insulin. Histopathological examination showed psoriasiform hyperplasia in the epidermis, with abundant infiltration of neutrophils in the dermis, consistent with the clinical diagnosis of PG. As per the modified Naranjo algorithm, the patient's total score was 7, indicating insulin to be the probable causative agent in our case. So, compiling temporal localisation of lesions to the site of administration of insulin and clinical, histopathological, and Naranjo score evidence all prompt the diagnosis of PG. Insulin stimulates the release of matrix‐metalloproteinases 9 which acts as endopeptidases and also results in the chemotaxis of neutrophils, causing ulcer formation. This is the first case reporting PG triggered by insulin. pubtype: Academic Journal doctype: case study pictorial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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