Varicela complicada con probable pioderma gangrenosa.
The following are five cases of probable pyoderma gangrenosum (PG). These cases are characterized by anemia and the presence of a necrotic ulcer with irregular borders, associated with varicella. The first two cases had a crusting phase which was complicated. The ulcers healed without the need for s...
| Publicado en: | Revista Mexicana de Pediatria Vol. 78; no. 3; pp. 108 - 114 |
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| Autores principales: | , , |
| Formato: | Artículo |
| Publicado: |
Sociedad Mexicana de Pediatria
mai/jun2011
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| Sumario: | The following are five cases of probable pyoderma gangrenosum (PG). These cases are characterized by anemia and the presence of a necrotic ulcer with irregular borders, associated with varicella. The first two cases had a crusting phase which was complicated. The ulcers healed without the need for surgery; however they required hospitalization, isolation, and twice a day wound cleaning using a local rifamycin. There were 3 cases that required surgical treatment. These were: A 4 year-old male, who had a single lesion on the left side of the thorax. A 2 year-old girl with varicella in the crusting phase, which she rapidly got worse. A 7 year old patient with varicella, and whose lesions got worse in a 4 day period. Both patients arrived to the Emergency Department and were admitted to the Intensive Care Unit, previously these patients had an out-patient management that consisted of at least 3 antibiotics without a favorable response; therefore there was a need to use a combined treatment that consisted of surgical debridement of necrotic tissue, wound closure with local skin flaps or skin grafts, along with continuous irrigation with rifamycin. Steroids were not used locally or systemically. There were no signs of neutrophilic infiltrates in the skin. Se describe la experiencia clínica en cinco niños con el diagnóstico clínico de probable pioderma gangrenosa (PG) que respondie- ron favorablemente al tratamiento quirúrgico: dos de ellos se caracterizaron por tener anemia y una úlcera necrótica con bordes irregulares, ambos asociados a varicela. En los dos primeros la fase de costra se complicó al profundizarse las lesiones hasta ser confluentes; pero en ambos las úlceras cerraron sin cirugía pero requirieron antibióticos; los otros tres recibieron tratamiento quirúrgico: en una niña, con lesión única en el hemitórax izquierdo y en otra de dos años de edad con varicela en fase de costra que se agravó rápidamente. Un varón de siete años, con varicela, mostró en cuatro días agravamiento de sus lesiones variolosas. Todos ingresaron al Servicio de Urgencias antes de ser hospitalizados en la Unidad de Terapia Intensiva donde fueron tratados hasta su egreso para luego continuar su tratamiento ambulatorio con antibióticos sin mostrar mejoría, por lo que se decidió tratarlos de manera combinada con la resección quirúrgica de tejido necrosado y cierre con colgajos locales, injertos e irrigación continua con rifamicina, sin el empleo de esteroides locales o sistémicos. Los resultados anatomopatológicos no mostraron que hubiese infiltración neutrofílica de la piel. |
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