Mesalazin ve Steroid ile Tedavi Edilen Pyoderma Gangrenozumun Eşlik Ettiği Ülseratif Kolit Vakası

Ayhan Balkan, Yasemin Balkan, Mustafa Namıduru, Ayşe Özlem Mete, Buğra Tolga Konduk, Abdullah Emre Yıldırım, Murat Taner Gülşen
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Öz


ABSTRACT

Pyoderma gangrenosum (PG) is a painful, recurrent ulcer causing, serious skin lesion which may accompany numerous diseases. The lesions may arise as single or multiple lesions simultaneously with systemic diseases such as ulcerative colitis, Crohn’s disease, polyarthritis, monoclonal gammopathy or spontaneously without any underlying disease. A 25-year-old male patient admitted with complaints of fever, abdominal pain, bloody diarrhea, painful and infected deep ulcers on his forhead, trunk and extremities. He had a rectosigmoidoscopy eight days ago in which ulcerative colitis (UC) was suspected and biopsies were taken from the ulcerated lesions on sigmoid colon mucosa. He was started on mesalazine and fluocortolone with diagnosis of UC and PG. The patients complaints, colonic and skin lesions rapidly subsided. Three months later he had an amputation of his right foot’s 3rd finger and had skin graft operations for skin defects on his right arm and right leg. He was discharged off hospital as his condition completely ameliorated. Here we report this case with abcess and skin ulcers resembling infection, with the purpose of emphasizing the importance of PG in differential diagnosis.

Key Words: Fluocortolone, mesalazine, pyoderma gangrenosum, ulcerative colitis

 

ÖZET

Pyoderma gangrenozum (PG), çok çeşitli hastalıklarla birlikte olabilen, ağrılı ve rekürren derin ülserasyonlarla seyredebilen ciddi bir deri lezyonudur. Lezyonlar, ülseratif kolit, Crohn hastalığı, poliartrit, monoklonal gammopati gibi sistemik hastalıklarla birlikte veya altta yatan bir hastalık olmaksızın tek veya çok sayıda görülebilirler. 25 yaşında erkek hasta, ateş, karın ağrısı, kanlı ishal ve alında, gövde ve ekstremitelerde yaygın ağrılı, enfekte ve derin ülserlerle başvurdu. Hastaya 8 gün önce rektosigmoidoskopi yapılmıştı ve ülseratif kolitten (ÜK) şüphelenilmişti ve sigmoid kolondaki ülsere lezyonlardan biyopsi alınmıştı. Hastaya ÜK ve PG teşhisiyle mesalazine ve fluocortolone başlandı. Hastanın şikayetleri, barsak ve deri lezyonları hızla geriledi. 3 ay sonra sağ ayak 3. parmağa amputasyon ve sağ koldaki ve sağ bacaktaki cilt defektleri için greft operasyonu yapıldı. Hasta şifa ile taburcu edildi. Biz bu vakayı, apse ve infekte görünümlü deri ülserleriyle gelen hastada PG’nin, ayırıcı tanıdaki yerini vurgulamak amacıyla rapor ettik.

Anahtar kelimeler: Fluocortolone, mesalazin, pyoderma gangrenozum, ülseratif kolit


Anahtar kelimeler


Fluocortolone, mesalazin, pyoderma gangrenozum, ülseratif kolit

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Referanslar


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