Multifocal Pyoderma Gangrenosum at Presentation in a Patient With Acute Severe Ulcerative Colitis

Jena, Anuraag; Sachan, Anurag; Singh, Anupam; Sharma, Vishal

doi:10.1093/ibd/izab309

Cited by 3 publications

(6 citation statements)

References 3 publications

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“…The authors delve into the plausible immunological mechanisms that underlie this correlation and emphasize the significance of interdisciplinary administration. 12 The precise etiological mechanisms that connect PG and SLE remain enigmatic. It has been postulated that dysregulated immune responses, which encompass abnormal neutrophil activation and malfunction, are implicated in the pathogenesis of both diseases.…”

Section: Discussionmentioning

confidence: 99%

“…In another case study, S. N. Jha et al demonstrated a female patient, aged 30 years, diagnosed with SLE, presented with PG affecting her lower limbs. The authors delve into the plausible immunological mechanisms that underlie this correlation and emphasize the significance of interdisciplinary administration 12 . The precise etiological mechanisms that connect PG and SLE remain enigmatic.…”

Section: Discussionmentioning

confidence: 99%

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Rare pyoderma gangrenosum correlated with systemic lupus erythematosus: A case report

Pourbagherian,

Javidi,

Taghizadieh

et al. 2023

Clinical Case Reports

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Key Clinical MessageThe simultaneous occurrence of pyoderma gangrenosum and systemic lupus erythematosus is exceedingly rare and poses diagnostic challenges due to the similarity of skin manifestations in both conditions. The exact relationship between the two conditions remains unclear; however, it is hypothesized that immune dysregulation and neutrophilic infiltration may play a role in the development of pyoderma gangrenosum in SLE patients. Clinicians should be vigilant in recognizing such uncommon associations to ensure prompt and appropriate management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rare pyoderma gangrenosum correlated with systemic lupus erythematosus: A case report

Pourbagherian,

Javidi,

Taghizadieh

et al. 2023

Clinical Case Reports

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“…Systemic treatments include corticosteroids, thiopurines, cyclosporine, infliximab, and intravenous antibiotics. 2 , 14 – 16 Although PG is not associated with UC disease activity, PG can be an extra-intestinal manifestation in patients with acute severe UC. 2 The previously diagnosed UC of our patient had not recently been treated, but the sigmoidoscopic findings had not worsened.…”

Section: Discussionmentioning

confidence: 99%

“… 2 , 14 – 16 Although PG is not associated with UC disease activity, PG can be an extra-intestinal manifestation in patients with acute severe UC. 2 The previously diagnosed UC of our patient had not recently been treated, but the sigmoidoscopic findings had not worsened. We suggest that the PG ulcer was not associated with UC activity, being rather immunologically triggered by the COVID-19 vaccine.…”

Section: Discussionmentioning

confidence: 99%

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Pyoderma Gangrenosum Triggered by COVID-19 Vaccination in a Patient with Ulcerative Colitis: A Case Report

Kim

Shim

Jeong

et al. 2022

The International Journal of Lower Extremity Wounds

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Pyoderma gangrenosum (PG) is a rare inflammatory skin disease that is difficult to diagnose. PG may be an extra-intestinal manifestation of ulcerative colitis (UC). In recent times, coronavirus disease (COVID-19) vaccines have caused various adverse cutaneous reactions. However, to the best our knowledge, combinations thereof have not been reported. We encountered a case of PG triggered by COVID-19 vaccination in a patient with UC. A 40-year-old woman developed severe pain and an abscess in the dorsum of the left foot after receiving the first dose of the messenger RNA (mRNA)-based Pfizer/BioNTech BNT162b2 COVID-19 vaccine. Severe painful ulcers with purulent necrosis and gaseous gangrene progressed rapidly along the extensor tendons and muscles to the toes and ankle. Although surgical debridement can worsen PG by triggering pathergy, we nonetheless performed wide debridement including partial extensor tenotomy with abscess drainage to prevent progression to pyogenic ankle arthritis and to rescue the toes. Antibiotics, corticosteroids, and anticoagulants were prescribed during surgical wound management via negative pressure therapy. After the lesion improved, the skin and soft tissue defect were covered using a superficial circumflex iliac artery perforator free flap and a split-thickness skin graft. The patient was satisfied with the foot salvage, and could walk unaided (without a brace or cane) from 8 weeks after the final surgery. PG may be rare even in UC patients, but mRNA-based COVID-19 vaccines may find an immunosuppressive niche. A high level of caution and suspicion of skin manifestations after vaccination is essential.

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Rare pyoderma gangrenosum correlated with systemic lupus erythematosus: A case report

pourbagherian,

javidi,

taghizadieh

et al. 2023

Preprint

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Multifocal Pyoderma Gangrenosum at Presentation in a Patient With Acute Severe Ulcerative Colitis

Cited by 3 publications

References 3 publications

Rare pyoderma gangrenosum correlated with systemic lupus erythematosus: A case report

Rare pyoderma gangrenosum correlated with systemic lupus erythematosus: A case report

Pyoderma Gangrenosum Triggered by COVID-19 Vaccination in a Patient with Ulcerative Colitis: A Case Report

Rare pyoderma gangrenosum correlated with systemic lupus erythematosus: A case report

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