Autoři uvádí kazuistiku 11letého děvčete, které přišlo pro hlubokou pyo-gangrenózní afekci v oblasti nad levou lopatkou. Nacházela se v oblasti acne comedonica. Celkový stav alterován nebyl. Diagnostická úvaha byla široká a využili jsme i možnosti histopatologického vyšetření.
The authors present the case of a 11-years old girl who came for a deep pyogenic and gangrenous affection in the area above the left soulder blade. The lesion was located in the area of acne comedonica. The overall condition was not altered. The diagnostic reasoning was broad and we also used the possibility of histopatological examination.
- MeSH
- Acne Vulgaris complications MeSH
- Biopsy methods MeSH
- Diagnosis, Differential MeSH
- Child MeSH
- Folliculitis * drug therapy MeSH
- Humans MeSH
- Oxacillin pharmacology therapeutic use MeSH
- Pyoderma Gangrenosum diagnosis therapy MeSH
- Staphylococcal Skin Infections drug therapy MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Úvod: Pyoderma gangrenosum (PG) je vzácné neinfekční zánětlivé onemocnění neznámé etiologie, které postihuje kůži i sliznice. Výskyt pyderma gangrenosum po redukční mammoplastice je velmi vzácná komplikace, která na první pohled vypadá jako infekční komplikace, ve skutečnosti se ale jedná o zánětlivé onemocnění. Případ: V této kazuistice popisujeme vzácnou pooperační komplikaci - pyoderma gangrenosum a její léčbu u naší pacientky, která podstoupila redukční mammoplastiku. Závěr: Včasné rozpoznání této komplikace je pro vyléčení pacienta zcela zásadní, protože primární chirurgická léčba vede ke zhoršení průběhu a je zde tedy kontraindikována. Pyoderma gangrenosum musí být primárně léčeno konzervativně kortikoidy.
Background: Pyoderma gangrenosum (PG) is a rare non-infectious inflammatory disease of unknown etiology that affects the skin and mucous membranes. The occurrence of pyoderma gangrenosum after a reduction mammoplasty is a very rare complication, which at first glance may seem like an infectious complication; in reality, however, it is an inflammatory disease. Case: This case report describes a rare postoperative complication – pyoderma gangrenosum and its appropriate treatment in our patient who underwent reduction mammoplasty. Conclusion: Early detection of this complication is essential for the patient’s recovery because the primary surgical treatment can lead to worsening of the condition and is therefore contraindicated in such a case. Pyoderma gangrenosum must be treated conservatively with corticosteroids.
- MeSH
- Adult MeSH
- Humans MeSH
- Mammaplasty adverse effects MeSH
- Postoperative Complications MeSH
- Pyoderma Gangrenosum * diagnosis etiology physiopathology therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Autoři popisují případ gravidní 34leté nemocné s potvrzenou diagnózou pyoderma gangrenosum. Systémová kortikoidní terapie nevedla k ústupu obtíží, proto byla zahájena kombinovaná imunosupresivní léčba (kortikoidy, cyklosporin A a mykofenolát-mofetil), která vedla k postupnému hojení projevů. Komplikací byl vznik gestačního a steroidního diabetu. Po roce a půl od počátku kožních potíží došlo k manifestaci ulcerózní kolitidy. Léčba infliximabem vedla k remisi pyoderma gangrenosum a ulcerózní kolitidy a k ukončení ostatní imunosupresivní léčby. Článek poskytuje přehled současných poznatků o diagnostice a možnostech terapie tohoto onemocnění.
The authors present a case of a 34-year-old pregnant patient with confirmed diagnosis of pyoderma gangrenosum (PG). As systemic corticosteroid therapy had not resulted in lesion clearing, combined immunosupressive treatment (corticosteroids, cyclosporine A and mycophenolate mofetil) was administered that led to gradual healing of the lesions. Steroid and gestational diabetes developed as complications of therapy. Furthermore, ulcerative colitis was diagnosed year and a half after the appearance of skin lesions. The administration of infliximab led to remission of PG as well as ulcerative colitis and enabled the discontinuation of previous combined immosuppresive treatment. The article reviews recent knowledge of diagnostics and therapeutical approaches in this disease.
- MeSH
- Diagnosis, Differential MeSH
- Adult MeSH
- Diabetes, Gestational MeSH
- Glucocorticoids administration & dosage adverse effects therapeutic use MeSH
- Hepatitis E chemically induced diet therapy MeSH
- Immunosuppressive Agents administration & dosage adverse effects therapeutic use MeSH
- Infliximab administration & dosage therapeutic use MeSH
- Drug Therapy, Combination MeSH
- Pregnancy Complications * MeSH
- Humans MeSH
- Forearm pathology MeSH
- Pyoderma Gangrenosum * diagnosis drug therapy pathology MeSH
- Colitis, Ulcerative diagnosis drug therapy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Cyclosporine administration & dosage therapeutic use MeSH
- Glucocorticoids administration & dosage therapeutic use MeSH
- Immunosuppressive Agents administration & dosage therapeutic use MeSH
- Humans MeSH
- Pyoderma Gangrenosum * diagnosis etiology drug therapy MeSH
- Wounds and Injuries complications MeSH
- Check Tag
- Humans MeSH
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Fatal Outcome MeSH
- Wound Healing MeSH
- Adrenal Cortex Hormones adverse effects therapeutic use MeSH
- Infections MeSH
- Drug Resistance MeSH
- Middle Aged MeSH
- Humans MeSH
- Treatment Failure MeSH
- Pyoderma Gangrenosum * diagnosis drug therapy therapy MeSH
- Aged MeSH
- Sepsis MeSH
- Lupus Erythematosus, Systemic complications MeSH
- Ulcer complications MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Pyoderma gangrenosum (PG) je vzácné onemocnění ze skupiny neutrofilních dermatóz, které může být prognosticky závažnou komorbiditou revmatoidní artritidy. Dominantní klinickou manifestací jsou primárně abakteriální kožní ulcerace s nepravidelným, indurovaným a fialově zabarveným okrajem (zvl. trup/DK). Předmětem případové studie je závažná forma PG u 73letého muže, která kompletně splňuje poslední verzi (2017) diagnostických kritérií PG a navíc má tyto zvláštnosti: (a) paralelní klinická manifestace PG a pozdně začínající (ACPA a RFs izotypy séropozitivní) revmatoidní artritidy, (b) ulcerace PG byla fenoménem maskujícím fibrinoidně-nekrotickou (revmatoidní) arteritidu a (c) odpověď na terapii kombinací glukokortikoidy-cyklosporin byla sice pomalá, ale doposud dlouhodobě setrvalá. Analýza triády "pyoderma gangrenosum - revmatoidní artritida - nekrotizující arteritida" je inspirativní v kontextu komplikované patogenní dráhy i jako klinický problém.
Pyoderma gangrenosum (PG) is a rare disorder from the group of neutrophilic dermatoses, partly as a serious comorbidity in rheumatoid arthritis. The main form of its clinical manifestation is abacterial necrotizing skin ulceration (-s) with irregular, indurative and violaceous border (espec. trunk/LE). The present study demonstrates a serious form of PG in a 73y old man; the last form of PG composite diagnostic criteria (2017) was completely fulfilled, and the observation was also associated with the following important aspects: (a) clinical manifestation of PG and elderly onset (ACPA and RFs isotypes seropositive) rheumatoid arthritis (EORA) were parallel, (b) PG ulceration was present as a masquerading phenomenon of fibrinoid-necrotic (rheumatoid) arteritis, and (c) the response to long-term glucocorticoid-cyclosporine combination was slow, but up to the presence persistent. Observation of the triade "pyoderma gangrenosum - rheumatoid arthritis - necrotizing arteritis" may be consider as an inspirative combination both in complicated pathways, and also as an important clinical problem.
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Antirheumatic Agents MeSH
- Arteritis * diagnosis pathology MeSH
- Cyclosporine administration & dosage therapeutic use MeSH
- Glucocorticoids therapeutic use MeSH
- Comorbidity MeSH
- Skin Ulcer diagnosis drug therapy pathology MeSH
- Humans MeSH
- Pyoderma Gangrenosum * diagnosis drug therapy pathology MeSH
- Arthritis, Rheumatoid diagnosis drug therapy pathology MeSH
- Aged MeSH
- Rare Diseases MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- Keywords
- asociovaná onemocnění, ulcerace, imunitní dysfunkce,
- MeSH
- Diagnosis, Differential MeSH
- Histological Techniques methods MeSH
- Humans MeSH
- Immune System Diseases MeSH
- Pyoderma Gangrenosum * diagnosis immunology therapy MeSH
- Ulcer MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- Keywords
- Sorelex,
- MeSH
- Anti-Infective Agents, Local MeSH
- Debridement MeSH
- Adult MeSH
- Pregnancy Complications MeSH
- Skin Ulcer nursing therapy MeSH
- Hyaluronic Acid analogs & derivatives therapeutic use MeSH
- Humans MeSH
- Bandages, Hydrocolloid MeSH
- Forearm MeSH
- Pyoderma Gangrenosum * diagnosis nursing therapy MeSH
- Pyridines therapeutic use MeSH
- Pregnancy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Leg MeSH
- Diagnosis, Differential MeSH
- Adult MeSH
- Humans MeSH
- Prednisone * therapeutic use MeSH
- Disease Progression MeSH
- Pyoderma Gangrenosum * diagnosis drug therapy physiopathology MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Sweetův syndrom neboli akutní febrilní neutrofilní dermatóza je poměrně vzácné kožní onemocnění, které může doprovázet celou řadu chorob či užívání některých léků. Práce uvádí popis případu 71letého muže s myelodysplastickým syndromem léčeným analogem růstového faktoru podporujícího tvorbu granulocytů (G-CSF) a cytostatikem azacitidinem, u kterého vznikly projevy Sweetova syndromu. Hematologické onemocnění i jeho léčba se mohly podílet na vzniku tohoto onemocnění. Autoři uvádí diagnostická kritéria Sweetova syndromu, přehled sdružených onemocnění a přehled současné literatury.
Sweet syndrome, alternatively called acute febrile neutrophilic dermatosis, is a quite rare skin disorder, which can be associated with a large group of diseases and use of certain drugs. This work reports a case of a 71-year-old male patient with myelodysplastic syndrome treated with an analogue of granulocyte colony-stimulating factor (G-CSF) and chemotherapeutic drug – azacitidine, in whom Sweet syndrome appeared. Both, haematological disease itself and drug used for its treatment, could be involved in the pathogenesis of this disease. Authors present diagnostic criteria of Sweet syndrome, list of associated states and overview of current literature.
- MeSH
- Antifungal Agents MeSH
- Azacitidine administration & dosage therapeutic use MeSH
- Blood Chemical Analysis MeSH
- Cefuroxime administration & dosage therapeutic use MeSH
- Cytarabine therapeutic use MeSH
- Filgrastim MeSH
- Hematologic Agents MeSH
- Herpes Labialis MeSH
- Herpes Zoster MeSH
- Adrenal Cortex Hormones therapeutic use MeSH
- Comorbidity MeSH
- Skin Diseases MeSH
- Humans MeSH
- Myelodysplastic Syndromes drug therapy MeSH
- Bone Marrow Diseases MeSH
- Antimetabolites, Antineoplastic MeSH
- Pyoderma Gangrenosum diagnosis therapy MeSH
- Rafoxanide administration & dosage therapeutic use MeSH
- Aged MeSH
- Sweet Syndrome * diagnosis etiology therapy MeSH
- Rare Diseases MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Case Reports MeSH
