Hatice Şule AKIN, Adil COŞKUN, Pınar KARATAY, Ekin ŞAVK, MEHMET HADİ YAŞA

Nadir görülen bir ülseratif kolit komplikasyonu: Piyoderma gangrenosum

Pyoderma gangrenosum, nadir görülen, ülserlerle karakterize, inflamatuvar bir deri hastalığıdır. Lezyonlar, ülseratif kolit, Crohn hastalığı, monoklonal gammopati gibi sistemik hastalıklarla birlikte veya altta yatan hastalık olmaksızın tek başına görülebilir. Bu makalede ülseratif kolitin aktivite kazanması ile ortaya çıkan yaygın pyoderma gangrenosum olgusunu sunduk. 21 yaşında erkek hasta, 1 aydır kanlı mukuslu dışkılama ile birlikte tüm vücutta yaygın ve şiddetli ağrılı, bazıları pürülan ve akıntılı ülserler ve nekrotik yaralarla kliniğimize başvurdu. Rektosigmoidoskopide aktif evre ülseratif kolit saptandı ve alınan biyopsilerle ülseratif kolit tanısı tekrar doğrulandı. Gaytanın mikroskopik incelemesi ile amibiazis ekarte edildi. Gram boyama ve kültür sonucu ile enfeksiyöz nedenler dışlandıktan sonra klinik ve histopatolojik bulgularla pyoderma gangrenosum tanısı konuldu. Olguya pyoderma gangrenosum ve ülseratif kolit tanısıyla 80 mg/gün metilprednisolon başlandı. Semptom ve bulgular 10 günde büyük oranda, 3 haftada ise tamamen düzeldi. Sonuç olarak, ülseratif kolitte nadir olarak görülen ve genellikle hastalık aktivitesinden bağımsız olarak seyreden pyoderma gangrenosum, hastalığın aktivitesi ile birlikte de ortaya çıkabilmekte ve yüksek doz steroid tedavisiyle de kısa sürede iyileşebilmektedir.

Anahtar Kelimeler:

Ülseratif kolit, Pyoderma Gangrenosum, kortikosteroid

A rare complication of ulcerative colitis: Pyoderma gangrenosum

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.

Keywords:

Ulcerative colitis, pyoderma gangrenosum, corticosteroid,

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