Pyoderma Gangrenosum, Defective Neutrophil Chemotaxis, and Leukemia

Pyoderma gangrenosum associated with acute myeloproliferative disease (? erythroleukaemia)

“…Other associations include active chronic hepatitis (Byrne, Hewitt and Summerly, 1976), immunosuppression (Haim et al, 1973) and disseminated intravascular coagulation (Staughton and Copeman, 1976). Alterations of cellular immunity have also been noted (Shore, 1976). Pyoderma gangrenosum has occurred in a case of acute lymphoblastic leukaemia maintained in remission by prednisolone, methotrexate and 6mercaptopurine, whilst non-specific leukaemia has occurred following 6-mercaptopurine, for preexisting pyoderma gangrenosum (Shore, 1976).…”

“…Alterations of cellular immunity have also been noted (Shore, 1976). Pyoderma gangrenosum has occurred in a case of acute lymphoblastic leukaemia maintained in remission by prednisolone, methotrexate and 6mercaptopurine, whilst non-specific leukaemia has occurred following 6-mercaptopurine, for preexisting pyoderma gangrenosum (Shore, 1976).…”

“…There have been a number of reports in the literature of this rare skin condition occurring in association with myeloproliferative diseases, including acute myeloblastic leukaemia, myelofibrosis, chronic myeloid leukaemia, polycythaemia rubra vera and acute myelomonocytic leukaemia (Perry and Winkelmann, 1972;Shore, 1976;Cramers, 1976).…”

“…Although most commonly reported (Domonkos, 1971) in association with ulcerative colitis and rheumatoid arthritis, pyoderma gangrenosum has also been noted in other clinical syndromes including acute and chronic myeloproliferative disease (Perry and Winkelmann, 1972;Shore, 1976;Cramers, 1976). The authors now describe a patient with an acute myeloproliferative disorder characterized by a pronounced and persistent peripheral blood basophilia and the occurrence of pyoderma gangrenosum initiated by sternal marrow puncture.…”

'Sticky' neutrophils, pathergic arthritis, and response to heparin in pyoderma gangrenosum complicating ulcerative colitis.

“…In both conditions neutrophil abnormalities have been reported, including decreased migration into skin windows, reduced chemotaxis, abnormal phagocytosis, and decreased bactericidal activity.14 [19][20][21] In the case presented here the pathergic nature of the patient's arthritis led us to the hypothesis that increased neutrophil adherence to vascular endothelium might be the underlying abnormality. The marginated neutrophils would then be ready to migrate into adjacent tissue in response to minor local trauma.…”