Ann Dermatol.  2010 Nov;22(4):422-425. 10.5021/ad.2010.22.4.422.

A Case of Pyoderma Gangrenosum with Ulcerative Colitis Treated with Mesalazine

• Lee JI
• Park HJ
• Lee JY
• Cho BK

• KMID: 2266179
• DOI: http://doi.org/10.5021/ad.2010.22.4.422

Abstract

Pyoderma gangrenosum (PG) manifests as recurrent deep ulceration of the skin and PG is associated with a variety of disorders. Approximately 30% of the cases of PG develop in patients with inflammatory bowel disease. A 34-year-old woman presented with a one-week history of recurrent ulcers on the right cheek and back. She was diagnosed with ulcerative colitis (UC) 4 years previously and with PG 1 year previously. The clinical course of the skin lesions followed the status of her UC. The patient's skin lesions and bowel symptoms were not improved with prednisolone. After she was started on mesalazine, we observed rapid resolution of skin lesions and bowel symptoms. Herein, we report a case of recurrent PG with UC, and we discuss the possible association between these two conditions, and the efficacy of mesalazine therapy for the treatment of PG combined with UC.

Keyword

Mesalazine; Pyoderma gangrenosum; Ulcerative colitis

MeSH Terms

Adult
Cheek
Colitis, Ulcerative
Female
Humans
Inflammatory Bowel Diseases
Mesalamine
Prednisolone
Pyoderma
Pyoderma Gangrenosum
Skin
Ulcer
Mesalamine
Prednisolone

Figure

• 

  Fig. 1 Painful, necrotic ulcer surrounded by a violaceous border on the right cheek (A) and the back (B). (C) Painful, necrotic ulcer on the periungual area of the right great toe.

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  Fig. 2 (A) Skin biopsy specimen showed perivascular and perifollicular infiltration of inflammatory cells from upper dermis to the subcutis (H&E, ×40). (B) Inlfammatory cells were composed of neutrophils and lymphohistiocytes (H&E, ×400).

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  Fig. 3 Healing ulcers with crust and hyperpigmentation on the right cheek (A), back (B) and the right great toe (C).

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