title: Pyoderma gangraenosum, a rare, but potentially fatal complication in paediatric oncology patients.
abstract: Pyoderma gangraenosum (PG) is a serious chronic, ulcerative skin disorder afflicting both adults and children. As PG is often associated with systemic diseases (>50%) such as inflammatory bowel disease, rheumatoid arthritis or haematological disorders, it requires a multidisciplinary approach. This disorder is not commonly reported in paediatrics; therefore children with PG represent a particularly difficult diagnostic challenge. Clinical diagnosis is often delayed and PG is only considered after eliminating other causes of cutaneous ulcers. We report a 4-year-old boy with secondary myelodysplastic syndrome following treatment for acute lymphoblastic leukaemia who presented with a massive inflammatory, ulcerative proliferation of the lower lip which was diagnosed as PG. We have reviewed the literature with reference to diagnostic criteria and treatment options of this disorder that is particularly rare in childhood.
authors.affiliation: Department of Neonatology, Heidelberg University, Germany. peter.meissner@urz.uni-heidelberg.de
authors.forename: P E
authors.initials: PE
authors.lastname: Meissner
authors.forename: U
authors.initials: U
authors.lastname: Jappe
authors.forename: C M
authors.initials: CM
authors.lastname: Niemeyer
authors.forename: A M
authors.initials: AM
authors.lastname: Peters
authors.forename: A
authors.initials: A
authors.lastname: Kulozik
authors.forename: E P
authors.initials: EP
authors.lastname: Zilow
mesh_terms: D000287:Administration, Topical; D000367:Age Factors; D002675:Child, Preschool; D006801:Humans; D006861:Hydrogen Peroxide / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D009190:Myelodysplastic Syndromes / Q000150:complications*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D017511:Pyoderma Gangrenosum / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D012008:Recurrence; D033581:Stem Cell Transplantation; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006861:Hydrogen Peroxide; D016559:Tacrolimus; D008775:Methylprednisolone