Koebner phenomenon in an ANCA-positive patient with pyoderma gangrenosum.
A male with pyoderma gangrenosum is reported. The clinical and histological features were typical. The initial lesions resolved with characteristic cribriform scars. A few days after the complete recovery, he developed several necrotizing focal lesions localized to the scarred areas. A further histological examination revealed a granulation tissue rich in neutrophils and signs of necrotizing vasculitis. We found a high titer of circulating perinuclear antineutrophil antibodies (p-ANCA), which are a serological marker for various systemic diseases. An immunological circulating factor has been repeatedly suggested to be the "primum movens" of pyoderma gangrenosum. We discuss the unusual clinical presentation interpreted as a Koebner phenomenon and the possible role of immune factors in enhancing circulating-endothelial cell interactions in relation to the pathogenesis of pyoderma gangrenosum.
Papi
M
M
Istituto Dermopatico Immacolata--I.R.C.C.S., Rome, Italy.
Didona
B
B
Chinni
L M
LM
Gobello
T
T
Mazzanti
C
C
De Pità
O
O
Cavalieri
R
R
D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D017511:Pyoderma Gangrenosum / Q000209:etiology / Q000276:immunology* / Q000473:pathology*; D014657:Vasculitis / Q000209:etiology / Q000276:immunology / Q000473:pathology
D019268:Antibodies, Antineutrophil Cytoplasmic