Pyoderma gangrenosum in childhood

Abstract

A review of our records disclosed eight children with pyoderma gangrenosum. All had associated inflammatory bowel disease, and four had arthritis. In three patients the bowel disease was severe and required resection of portions of the affected bowel. The cutaneous lesions had a chronic course (average duration, 2 1/2 years), and systemic therapy was required in seven cases. Previously reported cases of pyoderma gangrenosum in children are reviewed, and the management of this skin disorder in childhood is discussed.

Asymptomatic Inflammatory Bowel Disease Presenting With Mucocutaneous Findings

“…3,5,7 Pyoderma gangrenosum is uncommon in children, with 4% of cases reported in children Ͻ15 years old. 8 Although IBD is the most common underlying cause of pyoderma gangrenosum in children, pyoderma gangrenosum in children can be associated with several other systemic disorders including immunodeficiencies (primary and HIV related), leukemia, hepatitis, and arthritis. 9,10 The occurrence of pyoderma gangrenosum preceding gastrointestinal symptoms in IBD has only been described in a few patients.…”

“…9,10 The occurrence of pyoderma gangrenosum preceding gastrointestinal symptoms in IBD has only been described in a few patients. 6,8,11 Perianal lesions including skin tags, fistulas, fissures, and abscesses are characteristic of Crohn's disease and occur during the course of IBD in 60% to 82% of patients; however, 25% to 30% of patients show perianal lesions before gastrointestinal complaints. 12,13 The majority of our patients with Crohn's disease (6 of 8), as well as our 1 patient with ulcerative colitis, were noted to have perianal lesions before gastrointestinal symptoms.…”

Pustular Dermatosis of the Scalp Associated with Autoimmune Diseases

“…Very few cases with a condition identical to that described in the present patient have been reported. Peachey (l) and Powell and Perry (2) observed cases of pyoderma gangrenosum of the scalp associated with inflammatory bowel disease. However, these patients also revealed lesions on the extremities or the trunk.…”

“…It is extremely unusual to encounter a chronic destructive pyoderma which is confined to the scalp and which is not produced by any infectious organisms. A few cases of this kind have been .described under the title of pyoderma gangrenosum (1)(2)(3), but an exclusive localization to the scalp is admitted to be very rare.…”

Anogenital and buttock ulceration in infancy

“…Pyoderma gangrenosum, although rare in infancy, may present in this age group and is associated with an underlying systemic disease, such as haematological malignancies, inflammatory bowel disease or immunological abnormalities 44 . The clinical presentation of pyoderma gangrenosum is identical to the disease seen in adults.…”