Successful treatment of pyoderma gangrenosum in a patient winh ulcerative colitis and COVID-19 infection: case report

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Pyoderma gangrenosum is a rare inflammatory neutrophilic dermatosis, which causes ulceration of the skin. The condition is commonly associated with underlying systemic disorders such as inflammatory bowel disease, arthritis, and hematological disorders. Herein, we describe the case of a familiar association between pyoderma gangrenosum and ulcerative colitis complicated by the newly COVID-19 infection.

It is of particular clinical interest to address pyoderma gangrenosum lesions with concurrent treatment of associated disorders that may have influence on the course of the ulcer. Moreover, the therapy should cover as many diseases as possible while not being excessive to minimize possible side effects.

Thus, the selection of treatment that spans mutual pathophysiological features of all comorbidities represents the best option to make when handling pyoderma gangrenosum patients.

We present a case of the development of gangrenous pyoderma against the background of ulcerative colitis complicated by the new coronavirus infection COVID-19, which will raise awareness of gangrenous pyoderma as a relatively rare cause of ulcerative necrotic skin lesions, which can easily be confused with an infectious process.

Of particular clinical importance in the conditions of the COVID-19 pandemic is the correct treatment of gangrenous pyoderma. Only an integrated approach can give a positive result from the therapy.

作者简介

Nataliya Teplyuk

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: Teplyukn@gmail.com
ORCID iD: 0000-0002-5800-4800
SPIN 代码: 8013-3256

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow

Olga Grabovskaya

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: olgadoctor2013@yandex.ru
ORCID iD: 0000-0002-5259-7481
SPIN 代码: 1843-1090

MD, Cand. Sci. (Med.), Associate Professor

俄罗斯联邦, Moscow

Diana Kusraeva

I.M. Sechenov First Moscow State Medical University (Sechenov University)

编辑信件的主要联系方式.
Email: kysra1992@mail.ru
ORCID iD: 0000-0002-5633-7986
SPIN 代码: 1478-3503

Postgraduate Student

俄罗斯联邦, 4 build. 1, Bolshaya Pirogovskaya str., Moscow, 119991

Ekaterina Grekova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: grekova_kate@mail.ru
ORCID iD: 0000-0002-7968-9829
SPIN 代码: 8028-5545

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Danila Koriakin

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: danila110920021@gmail.com
ORCID iD: 0000-0003-3619-206X

Student

俄罗斯联邦, Moscow

Anastasia Kostenko

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: anastasiya.k9716@gmail.com
ORCID iD: 0000-0002-4115-540X

MD

俄罗斯联邦, Moscow

参考

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2. Fig. 1. Patient, 72 years old. Ulcerative pyoderma gangrenosum. Оval ulcer on the skin of the abdomen 24×45 cm in size with the undermined edge with violaceous borders, the surface of the ulcer is filled with fibrin granulations.

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3. Fig. 2. The same patient. Histologic image: mixed inflammatory infiltrate with a predominance of neutrophils and signs of leukocytoclastic vasculitis. Hematoxylin and eosinstaining, ×200.

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4. Fig. 3. The same patient. External therapy: а ― topical corticosteroids along the periphery to the area of erythema; b ― application of a nonadhesive lipidоcolloid wound dressing.

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5. Fig. 4. The same patient. Clinical image after the conducted treatment: complete scarring of the ulcer.

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版权所有 © Teplyuk N.P., Grabovskaya O.V., Kusraeva D.T., Grekova E.V., Koriakin D.A., Kostenko A.Y., 2023

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