Akademik Veri Yönetim Sistemi
Akademik Gastroenteroloji Dergisi, cilt.10, sa.2, ss.87-90, 2011 (Hakemli Dergi)
Pyoderma gangrenosum, nadir görülen, ülserlerle karakterize, inflamatuvar bir deri hastal›¤›d›r. Lezyonlar, ülseratif kolit, Crohn hastal›¤›, monoklonal gammopati gibi sistemik hastal›klarla birlikte veya altta yatan
hastal›k olmaks›z›n tek bafl›na görülebilir. Bu makalede ülseratif kolitin
aktivite kazanmas› ile ortaya ç›kan yayg›n pyoderma gangrenosum olgusunu sunduk. 21 yafl›nda erkek hasta, 1 ayd›r kanl› mukuslu d›flk›lama ile birlikte tüm vücutta yayg›n ve fliddetli a¤r›l›, baz›lar› pürülan ve
ak›nt›l› ülserler ve nekrotik yaralarla klini¤imize baflvurdu. Rektosigmoidoskopide aktif evre ülseratif kolit saptand› ve al›nan biyopsilerle ülseratif kolit tan›s› tekrar do¤ruland›. Gaytan›n mikroskopik incelemesi ile
amibiazis ekarte edildi. Gram boyama ve kültür sonucu ile enfeksiyöz
nedenler d›flland›ktan sonra klinik ve histopatolojik bulgularla pyoderma gangrenosum tan›s› konuldu. Olguya pyoderma gangrenosum ve
ülseratif kolit tan›s›yla 80 mg/gün metilprednisolon baflland›. Semptom
ve bulgular 10 günde büyük oranda, 3 haftada ise tamamen düzeldi.
Sonuç olarak, ülseratif kolitte nadir olarak görülen ve genellikle hastal›k aktivitesinden ba¤›ms›z olarak seyreden pyoderma gangrenosum,
hastal›¤›n aktivitesi ile birlikte de ortaya ç›kabilmekte ve yüksek doz
steroid tedavisiyle de k›sa sürede iyileflebilmektedir.
Pyoderma gangrenosum is a rare inflammatory skin illness characterized by ulcers. It can be seen with unknown etiology or with some
systemic disorders such as ulcerative colitis, Crohn’s disease and monoclonal gammopathy. Ulcers may be seen as single or multiple. We
present in this article a pyoderma gangrenosum case that occurred
with the activation of ulcerative colitis. A 21-year-old male was admitted to our hospital with a one-month history of symptoms of bloody
and mucoid defecation with general intense body pain, ulcers (some
with purulent secretion) and necrotic wounds. Rectosigmoidoscopy
showed active state ulcerative colitis, and this diagnosis was confirmed with biopsies. Amebiasis was excluded with stool examination.
After exclusion of infectious causes with gram staining and culture,
the patient was diagnosed as pyoderma gangrenosum with histopathological findings. We started high-dose corticosteroid with the diagnosis of pyoderma gangrenosum and ulcerative colitis. Symptoms and
findings significantly regressed in 10 days and totally healed in three
months. In conclusion, pyoderma gangrenosum (which rarely occurs
and usually does not correlate with the disease activity) can be seen
with disease activity and may heal with high-dose steroid treatment in
a short time