title: Tracheobronchial pulmonary disease associated with pyoderma gangrenosum.
abstract: We report a tracheobronchial pulmonary manifestation caused by pyoderma gangrenosum, a neutrophilic dermatosis of unknown etiology. A 54-year-old man presented with pulmonary infiltrates followed by multiple painful cutaneous pustules on the scrotum. Skin biopsy showed pronounced neutrophilic infiltration without microorganism or granuloma, consistent with pyoderma gangrenosum. Bronchoscopy revealed multiple scattered polypoid nodules with a yellowish irregular surface from the trachea to bilateral bronchi; the appearance closely mimicked that of a skin lesion. Endobronchial biopsy demonstrated inflamed granulation and necrosis with infiltration by numerous neutrophils without vasculitis or granulomas, interpreted as pyoderma gangrenosum of the bronchi. Although the etiology of pyoderma gangrenosum is poorly understood, this case suggests that a common pathogenesis may account for the simultaneous cutaneous and airway inflammation.
authors.affiliation: Division of Respiratory Medicine, Department of Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kanoh
authors.forename: Hideo
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Ken
authors.initials: K
authors.lastname: Sato
authors.forename: Kazuo
authors.initials: K
authors.lastname: Motoyoshi
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Aida
mesh_terms: D001999:Bronchoscopy; D006801:Humans; D008171:Lung Diseases / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D012611:Scrotum / Q000473:pathology