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DOI: 10.1055/a-1158-1823
Disseminierte, therapieresistente Hautulzerationen bei einem 51-jährigen Patienten – Der Fall eines multifokalen Pyoderma gangraenosum
Disseminated Skin Ulcers in a 51-Year Old Patient – A Case of Multifocal Pyoderma gangrenosum
Zusammenfassung
Bei dem Pyoderma gangraenosum (PG) handelt es sich um eine seltene autoinflammatorische Erkrankung aus der Familie der neutrophilen Dermatosen, welche aufgrund ihrer zahlreichen klinischen Varianten und Differenzialdiagnosen bei zum Teil unbefriedigendem Therapieansprechen selbst für Dermatologen eine große Herausforderung darstellen können. Berichtet wird über einen 51-jähringen Mann mit multiplen, hartnäckigen Ulzerationen der Extremitäten, bei dem unter systemischer Kortikosteroid- und Ciclosporin A-Therapie unter adaptierten Wundbehandlungen ein gutes Therapieansprechen verzeichnet werden konnte.
Abstract
Due to its multiple clinic variants and differential diagnoses, it could be very challenging even for dermatologists to diagnose pyoderma gangrenosum, a rare auto-inflammatory disease from the spectrum of neutrophil dermatoses with sometimes inadequate therapeutic response. We report on the case of a 51-year old male with multiple recalcitrant ulcers of the extremities that showed a good response to the treatment with systemic corticosteroids and ciclosporine A in addition to specific wound therapy.
Publication History
Article published online:
17 June 2020
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Literatur
- 1 Ahn C, Negus D, Huang W. Pyoderma gangrenosum: a review of pathogenesis and treatment. Expert Rev Clin Immunol 2018; 14: 225-233 DOI: 10.1080/1744666x.2018.1438269.
- 2 Jockenhofer F, Herberger K, Schaller J. et al. Trizentrische Analyse von Kofaktoren und Komorbiditat des Pyoderma gangraenosum. J Dtsch Dermatol Ges 2016; 14: 1023-1031 DOI: 10.1111/ddg.12791_g.
- 3 Wollina U. Pyoderma gangrenosum – a review. Orphanet J Rare Dis 2007; 2: 19 DOI: 10.1186/1750-1172-2-19.
- 4 Wollina U. Pyoderma gangrenosum – a systemic disease?. Clin Dermatol 2015; 33: 527-530 DOI: 10.1016/j.clindermatol.2015.05.003.
- 5 Langan SM, Groves RW, Card TR. et al. Incidence, mortality, and disease associations of pyoderma gangrenosum in the United Kingdom: a retrospective cohort study. J Invest Dermatol 2012; 132: 2166-2170 DOI: 10.1038/jid.2012.130.
- 6 Braswell SF, Kostopoulos TC, Ortega-Loayza AG. Pathophysiology of pyoderma gangrenosum (PG): an updated review. J Am Acad Dermatol 2015; 73: 691-698 DOI: 10.1016/j.jaad.2015.06.021.
- 7 Marzano AV, Borghi A, Meroni PL. et al. Pyoderma gangrenosum and its syndromic forms: Evidence for a link with autoinflammation. Br J Dermatol 2016; 175: 882-891 DOI: 10.1111/bjd.14691.
- 8 Ormerod AD, Thomas KS, Craig FE. et al. Comparison of the two most commonly used treatments for pyoderma gangrenosum: results of the STOP GAP randomised controlled trial. BMJ 2015; 350: h2958 DOI: 10.1136/bmj.h2958.
- 9 Wollina U. Clinical management of pyoderma gangrenosum. Am J Clin Dermatol 2002; 3: 149-158
- 10 Marzano AV, Trevisan V, Lazzari R. et al. Pyoderma gangrenosum: study of 21 patients and proposal of a ‘clinicotherapeutic’ classification. J Dermatolog Treat 2011; 22: 254-260 DOI: 10.3109/09546631003686069.
- 11 Quist SR, Kraas L. Treatment options for pyoderma gangrenosum. J Dtsch Dermatol Ges 2017; 15: 34-40 DOI: 10.1111/ddg.13173.
- 12 Kolios AG, Maul JT, Meier B. et al. Canakinumab in adults with steroid-refractory pyoderma gangrenosum. Br J Dermatol 2015; 173: 1216-1223 DOI: 10.1111/bjd.14037.
- 13 Ye MJ, Ye JM, Wu L. et al. A challenging diagnosis: case report of extensive pyoderma gangrenosum at multiple sites. Clin Cosmet Investig Dermatol 2014; 7: 105-109 DOI: 10.2147/CCID.S60229.
- 14 Fulbright RK, Wolf JE, Tschen JA. Pyoderma gangrenosum at surgery sites. J Dermatol Surg Oncol 1985; 11: 883-886
- 15 von den Driesch P. Pyoderma gangrenosum: a report of 44 cases with follow-up. Br J Dermatol 1997; 137: 1000-1005