Medical and surgical management of paraneoplastic pyoderma gangrenosum--a case report and review of the literature.
We present a case of a 44-year-old male with pyoderma gangrenosum (PG) presenting simultaneously with diagnosis of acute leukemia. His skin disease was stabilized with corticosteroids and most lesions cleared after chemotherapy-induced remission of the malignancy, but the largest lesion remained necrotic. Surgical treatment of the large necrotic ulcer included debridement followed by split-thickness skin graft while maintaining corticoid therapy. Unfortunately, relapse of the pyoderma gangrenosum with bullous lesions heralded relapse of the ultimately fatal malignancy. This case illustrates: (1) PG presenting simultaneously with a haematologic malignancy (2) Relapse with atypical bullous lesions with return of the malignancy and (3) The use of surgical modalities in managing patients with PG, a disease notorious for surgical complications.
Lamet
S
S
Department of Dermatology, University Hospital, Antwerp, België.
Bracke
A
A
Geluykens
E
E
Vlieghe
E
E
Seymons
K
K
Gadisseur
A P
AP
Vrelust
I
I
Van Marck
V
V
Somville
J
J
Lambert
J
J
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D010257:Paraneoplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D017511:Pyoderma Gangrenosum / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents