Pyoderma gangrenosum with spleen involvement and monoclonal IgA gammopathy.
A 46-year-old man with a 3-year history of pyoderma gangrenosum was admitted with ulceration (6 x 5 cm), on the right leg. Previously he had been treated with tapering doses of prednisone (maximum dose 1 mg/kg per day); however, he had had a few exacerbations following each taper of prednisone dose. Immunoelectrophoresis demonstrated monoclonal IgA gammopathy of lambda light chains. Abdominal echography and abdominal computed tomographic scan revealed multiple splenic abscesses. Treatment was started with oral prednisone (1 mg/kg per day) and cyclosporin (5 mg/kg per day) and 6 weeks later complete remission was achieved. Systemic involvement in pyoderma gangrenosum is very rare, and according to our knowledge there are only a few cases with spleen involvement.
Mijuşković
Z P
ZP
Department of Dermatology and Venereology, Military Medical Academy, Crnotravska 17, Belgrade 11002, Serbia and Montenegro. mijuskovic@yubc.net
Zecević
R D
RD
Pavlović
M D
MD
D016572:Cyclosporine / Q000627:therapeutic use; D006801:Humans; D006942:Hypergammaglobulinemia / Q000209:etiology*; D007070:Immunoglobulin A; D007147:Immunoglobulin Light Chains; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D017511:Pyoderma Gangrenosum / Q000150:complications* / Q000188:drug therapy; D013158:Splenic Diseases / Q000175:diagnosis / Q000209:etiology*
D007070:Immunoglobulin A; D007147:Immunoglobulin Light Chains; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011241:Prednisone