Pyoderma gangrenosum in refractory celiac disease: a case report

BMC Gastroenterology

Case Report

Elena Campione¹  Giovanni Monteleone¹  Irene Marafini¹  Silvia Sedda¹  Francesco Pallone¹  Roberta Caruso¹  Augusto Orlandi² 

[1] Department of Systems Medicine, University of Rome “Tor Vergata”, Via Montpellier, 1, 00133, Rome, Italy;Department of Systems Medicine, University of Rome “Tor Vergata”, Via Montpellier, 1, 00133, Rome, Italy;Department of Biomedicine and Prevention, Anatomic Pathology Unit, University of Rome “Tor Vergata”, Rome, Italy;

关键词: Gluten;    Cutaneous ulcers;    Celiac disease;    Pyoderma gangrenosum;   

DOI  :  10.1186/1471-230X-13-162

 received in 2013-08-07, accepted in 2013-11-22,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundPyoderma gangrenosum is an inflammatory neutrophilic dermatosis characterized by painful cutaneous ulcerations and often associated with systemic inflammatory and neoplastic diseases. Here we report the first case of pyoderma gangrenosum in a patient with refractory celiac disease.Case presentationA 52-year-old woman with a previously diagnosed refractory celiac disease resistant to steroids and immunosuppressive drugs presented to our hospital for a rapidly growing, painful inflammatory skin lesion of the left leg. Physical examination revealed a painful lesion with focal ulceration, necrosis and pus discharge with active inflammatory borders at the external part of the left leg. Histological evaluation of a skin biopsy and analysis of inflammatory cytokines and matrix-degrading proteases in lesional skin samples confirmed the clinical suspicion of pyoderma gangrenosum. Treatment with oral prednisone was rapidly followed by a complete healing of the skin lesion but no improvement of symptoms/signs of malabsorption.ConclusionTreatment of the patient with systemic steroids healed the skin lesion without improving the underlying refractory celiac disease. This observation raises the possibility that refractory celiac disease and pyoderma gangrenosum may be immunologically different.

【 授权许可】

Unknown   
© Sedda et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.