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首页> 外文期刊>The Journal of dermatology >Bullous pyoderma gangrenosum of the bilateral dorsal han
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Bullous pyoderma gangrenosum of the bilateral dorsal han

机译：双侧背汗大疱性坏疽性坏疽

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摘要

Pyoderma gangrenosum (PG) shows characteristic non-infectious ulcers that are commonly associated with systemic diseases such as inflammatory bowel diseases, myeloproliferative disorders or aortitis syndrome. The typical clinical appearance is undermining ulcers with reddish and irregular borders on the legs. As PG has these notable signs, the diagnosis is relatively easy and its treatment depends on the severity of underlying complications. We report a case of a 60-year-old Japanese man, diagnosed with bullous PG, who also had been suffering from mye-loperoxidase antineutrophil cytoplasmic antibody-positive microscopic polyangiitis and pulmonary aspergillosis. This case displayed soft whitish ulcers that existed on the rough ulcer base, with irregular borders, on his bilateral dorsal hands. Initially, it seemed to be cutaneous secondary aspergillosis because the host was already infected with pulmonary aspergillosis in both lungs. The differential diagnosis of PG from aspergillosis was from the sterile builae or neutrophilic bullae on his right forearm, which evolved into ulcers in a few days. This case was finally diagnosed as bullous PG and a topical glucocorticoid was very effective to epithelize the ulcers in 2-3 weeks.
机译：坏疽性脓皮病（PG）表现出典型的非感染性溃疡，通常与全身性疾病如炎性肠病，骨髓增生性疾病或主动脉炎综合征相关。典型的临床表现是破坏溃疡，腿部带红色和不规则的边界。由于PG具有这些明显的体征，因此诊断相对容易，其治疗取决于潜在并发症的严重程度。我们报告了一例60岁的日本男子，被诊断患有大疱性PG，他也患有髓过氧化物酶抗中性粒细胞胞浆抗体阳性的显微镜性多血管炎和肺曲霉病。该病例显示出在其粗糙的溃疡基底上存在软的白色溃疡，该溃疡在他的双侧背侧手上具有不规则的边界。最初，它似乎是皮肤继发性曲霉病，因为宿主已经在两个肺部感染了肺曲霉病。曲霉菌性前列腺炎的鉴别诊断来自其右前臂的无菌builae或中性粒细胞大疱，几天后演变为溃疡。该病例最终被诊断为大疱性PG，局部用糖皮质激素在2-3周内对上皮化溃疡非常有效。

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