Pyoderma gangrenosum with splenic involvement

Abstract

Pyoderma gangrenosum (PG) is a non-infectious disease characterized by necrotizing, ulcerative, and painful skin. The incidence of PG is approximately 3–10 cases per million people per year. Pyoderma gangrenosum is rarely observed in children, which accounts for less than 4%, but it primarily affects adults between the ages of 25 and 54 years old without gender preference. Here, we present a case report of a 16-month-old toddler diagnosed with pyoderma gangrenous with splenic involvement. The young age of the patient and extracutaneous manifestation are of high interest.

Pyoderma Gangrenosum with Splenic Abscess- A Rare Association

“…[ 4 5 6 7 8 9 10 11 12 13 ] There are four reports of pediatric PG with associated splenic involvement ranging from a 16-month child to 14 years of age. [ 14 15 16 17 ] It is slightly more frequent in males. [ 5 6 7 8 13 14 15 16 ] PG with splenic involvement can be associated with additional involvement of other organs including the liver, kidney, lung, and bone.…”

“…[ 11 15 ] Laboratory abnormalities observed in these cases include leukocytosis with neutrophilia, anemia, raised erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP). [ 4 5 6 7 8 9 10 11 12 13 14 15 16 17 ] The differential diagnoses for splenic lesions in PG include vasculitis, tumor, and infections. The imaging studies aid in the diagnosis and follow-up for these patients.…”

“…The therapy for PG in patients with underlying visceral involvement involves the use of anti-inflammatory agents, including antibiotics, corticosteroids, immunosuppressive agents, and biologic agents. [ 4 5 6 7 8 9 10 11 12 13 14 15 16 17 ] In most cases, the disease responded well to glucocorticosteroids, whereas a few patients were managed with immunosuppressants like cyclosporine[ 8 9 ,, 10 11 12 13 ] and dapsone. [ 4 ] In refractory cases, biologicals such as infliximab, adalimumab, and etanercept were used.…”

“…A total of 14 cases of pyoderma gangrenosum with splenic involvement have been reported to date with four cases affecting children. [ 4 5 6 7 8 9 10 11 12 13 14 15 16 17 ] We report a case of a 38-year-old female with pyoderma gangrenosum and extracutaneous manifestation presenting as asymptomatic splenic abscess.…”

Idiopathic pyoderma gangrenosum

“…Described in 1930 by Brunstig et al [2]. It is a noninfectious disease characterized by necrotizing, ulcerative and painful skin, whose incidence is approximately 3-10 cases per million people per year and it is rarely observed in children, accounting for less than 4% of cases, but primarily affects adults between the ages of 25 and 54 years old without gender preference [3]. PG can associate with inflammatory, infectious or malignant pathologies or be idiopathic [4].…”