PUSTULAR PYODERMA GANGRENOSUM AND INFLAMMATORY BOWEL DISEASE – HEALING AFTER PROCTOCOLECTOMY

  • Pedro Andrade Interno do Internato Complementar de Dermatologia e Venereologia/Resident, Dermatology and Venereology
  • Maria Manuel Brites Assistente Hospitalar de Dermatologia e Venereologia/Consultant, Dermatology and Venereology
  • Henrique Alexandrino Assistente Hospitalar de Cirurgia Geral/Consultant, General Surgery Specialist
  • Américo Figueiredo Director de Serviço; Professor Doutor de Dermatologia e Venereologia dos Hospitais da Universidade de Coimbra/ Head of Dermatology Department; Professor of Dermatology and Venereology of Coimbra University Serviço de Dermatologia, Hospitais da Universidade de Coimbra, EPE, Coimbra, Portugal

Abstract

We present the case of a 67-year-old patient observed with multiple painful violaceous plaques with central pustules on distal lower limbs, rapidly transforming into deep ulcers with infiltrated undermined borders and centrifuge progression, associated with mucous bloody diarrhea, oral erosions and hyperthermia in the previous three months. Histopathologic skin examination was consistent with the diagnosis of pyoderma gangrenosum (PG). Subtotal colonoscopy showed a severe continuous rectocolitis, consistent with unspecific inflammatory bowel disease (IBD). Due to colonic perforation, the patient was submitted to left colectomy, and afterwards to total proctocolectomy. Treatment with topical corticosteroids was performed and complete ulcer healing was observed three months after surgery, without recurrence in the following 2 years. Pustular PG is a rare condition; the relevance of this case is supported not only by the synergic evolution of severe pustular PG and IBD, but also by the prompt regression of the former after proctoco- lectomy.

KEYWORDS – Pyoderma Gangrenosum; Inflammatory Bowel Diseases; Proctocolectomy.

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Published
2011-09-28
How to Cite
Andrade, P., Brites, M. M., Alexandrino, H., & Figueiredo, A. (2011). PUSTULAR PYODERMA GANGRENOSUM AND INFLAMMATORY BOWEL DISEASE – HEALING AFTER PROCTOCOLECTOMY. Journal of the Portuguese Society of Dermatology and Venereology, 69(3), 461. https://doi.org/10.29021/spdv.69.3.84
Section
Case Reports

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