title: Pyoderma gangrenosum associated with ulcerative colitis.
abstract: We report the case of a 45-year old man with non-healing ulcers located on his chest, lumbal, sacral, retroauricular areas and forehead. Both clinical and histopathological examinations suggested pyoderma gangrenosum (PG). For six months the diagnosis of ulcerative colitis was established. PG in our patient was presented as a rapidly enlarging, painful ulcer with purple, undermined edges and a necrotic, haemorrhagic base. Initially, he was treated with a high dosage of peroral glucocorticosteroid, sulfasalazine, and systemic antibiotics, together with daily wound care. Ulceration partially regressed. Total colonoscopy showed pancolitis. When the dose of glucocorticosteroids was tapered down to 35 mg, new ulcerations on his right thigh and abdomen were formed. He also developed E. coli sepsis and flare up of bowel disease. Azathioprine, together with two pulse doses of glucocorticosteroids and antibiotics, were administered. He was scheduled for a total colectomy. The management of PG continues to be a therapeutic challenge.
authors.affiliation: University Department of Dermatology and Venereology, Zagreb University Hospital Center, Salata 4, HR-10000 Zagreb, Croatia. suzana.ljubojevic@zg.htnet.hr
authors.forename: Suzana
authors.initials: S
authors.lastname: Ljubojević
authors.forename: Visnja
authors.initials: V
authors.lastname: Milavec-Puretić
authors.forename: Vesna
authors.initials: V
authors.lastname: Sredoja-Tisma
authors.forename: Jaka
authors.initials: J
authors.lastname: Rados
authors.forename: Mirjana
authors.initials: M
authors.lastname: Kalauz
authors.forename: Irena
authors.initials: I
authors.lastname: Hrstić
mesh_terms: D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000209:etiology* / Q000473:pathology / Q000628:therapy