[Pyoderma gangrenosum with aseptic spleen abscess].
BACKGROUND
Pyoderma gangrenosum is a neutrophilic dermatosis in which systemic involvement is rare. It may be associated with systemic disease. We report a case of pyoderma gangrenosum in the spleen.


METHODS
A 68-year-old man presenting pyoderma gangrenosum with pustules and stage I multiple myeloma was admitted for asthenia and abdominal pain. There were no skin lesions. Laboratory tests showed inflammatory syndrome with polynuclear leucocytes of 25,000/mm(3). CAT scans and abdominal ultrasound revealed a splenic abscess. A spleen biopsy was performed and histological examination showed polynuclear leukocyte infiltration, while cultures were negatives. Diagnosis of pyoderma gangrenosum with splenic involvement was made. Increased systemic corticosteroid therapy produced a successful outcome. Haematological findings remained unchanged.


CONCLUSIONS
Spleen involvement in pyoderma gangrenosum is very rare and can mimic an infectious process. In such cases, routine screening is essential for associated diseases, particularly haematological malignancies.
Brahimi
N
N
Service de dermatologie, hôpital Bichat, Assistance publique-Hôpitaux de Paris, université Paris-VII Denis-Diderot, 46, rue Henri-Huchard, 75877 Paris cedex 18, France.
Maubec
E
E
Boccara
O
O
Marinho
E
E
Valeyrie-Allanore
L
L
Lecaille
C
C
Sebban
V
V
Hersent
B
B
Picard-Dahan
C
C
Descamps
V
V
Crickx
B
B
D000038:Abscess / Q000150:complications*; D000368:Aged; D006225:Hand / Q000473:pathology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D017511:Pyoderma Gangrenosum / Q000150:complications*; D013158:Splenic Diseases / Q000150:complications*