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Genital Ulcerative Pyoderma Gangrenosum in Behçet's Disease: A Case Report and Review of the Literature.

Ozuguz P, Kacar SD, Manav V, Karaca S, Aktepe F, Ulu S - Indian J Dermatol (2015 Jan-Feb)

Bottom Line: Behçet's disease (BD), first described by Hulusi Behcet, is a multisystemic disease characterized by recurrent oral and genital ulcerations, ocular and cutaneous lesions, arthritis and vascular disease.A 33-year-old woman complained a severe genital ulcer.She had a purulent oozing and stinky ulceration on the right side of labium minor measuring 5-8 cm.

View Article: PubMed Central - PubMed

Affiliation: Afyon Kocatepe University Department of Dermatology, Afyon, Turkey.

ABSTRACT
Behçet's disease (BD), first described by Hulusi Behcet, is a multisystemic disease characterized by recurrent oral and genital ulcerations, ocular and cutaneous lesions, arthritis and vascular disease. Pyoderma gangrenosum (PG) is a rare, chronic, sterile pustular and progressive ulcerative process of unknown cause; sometimes can participate in the differential diagnosis of Behcet's ulceration. A 33-year-old woman complained a severe genital ulcer. She had a purulent oozing and stinky ulceration on the right side of labium minor measuring 5-8 cm. A punch biopsy at ulcer margin showed that the lymphocytic panniculitis was extending to the subcutaneous fat tissue without fibrin deposition or necrotic changes in the vessel wall. Based on the clinical and histological findings, she was diagnosed as genital ulcerative PG, which occurred during the exacerbation of BD.

No MeSH data available.


Related in: MedlinePlus

The patients lesion healed with scar
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Figure 4: The patients lesion healed with scar

Mentions: On dermatological examination; she had a purulent oozing and stinky ulceration on the right side of labium minor measuring 5-8 cm. There was no lymphadenopathy. Repeated smears and cultures for bacteria and fungi were negative. Physical examination revealed no systemic involvement. On laboratory examination increased erythrocyte sedimentation rate, white blood cell count and C-reactive protein (CRP); with anemia were detected. The X-ray imaging of the chest was normal. The punch biopsy of ulcer margin showed the lymphocytic panniculitis, which was extending to the subcutaneous fat tissue without fibrin deposition or necrotic changes in the vessel wall [Figures 2 and 3]. The patient of erythrocyte sedimentation rate and CRP levels were higher and she had three oral ulcers. Although the histological findings are not very typical for PG, based on the clinical and histological findings, our case was diagnosed as genital ulcerative PG, which occurred during the exacerbation of BD. Ulcer markedly improved and healed with scarring after oral prednisolone therapy with 20 mg/day for 8 weeks together with topical sucralfate and mometasone furoate therapy [Figure 4].


Genital Ulcerative Pyoderma Gangrenosum in Behçet's Disease: A Case Report and Review of the Literature.

Ozuguz P, Kacar SD, Manav V, Karaca S, Aktepe F, Ulu S - Indian J Dermatol (2015 Jan-Feb)

The patients lesion healed with scar
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318036&req=5

Figure 4: The patients lesion healed with scar
Mentions: On dermatological examination; she had a purulent oozing and stinky ulceration on the right side of labium minor measuring 5-8 cm. There was no lymphadenopathy. Repeated smears and cultures for bacteria and fungi were negative. Physical examination revealed no systemic involvement. On laboratory examination increased erythrocyte sedimentation rate, white blood cell count and C-reactive protein (CRP); with anemia were detected. The X-ray imaging of the chest was normal. The punch biopsy of ulcer margin showed the lymphocytic panniculitis, which was extending to the subcutaneous fat tissue without fibrin deposition or necrotic changes in the vessel wall [Figures 2 and 3]. The patient of erythrocyte sedimentation rate and CRP levels were higher and she had three oral ulcers. Although the histological findings are not very typical for PG, based on the clinical and histological findings, our case was diagnosed as genital ulcerative PG, which occurred during the exacerbation of BD. Ulcer markedly improved and healed with scarring after oral prednisolone therapy with 20 mg/day for 8 weeks together with topical sucralfate and mometasone furoate therapy [Figure 4].

Bottom Line: Behçet's disease (BD), first described by Hulusi Behcet, is a multisystemic disease characterized by recurrent oral and genital ulcerations, ocular and cutaneous lesions, arthritis and vascular disease.A 33-year-old woman complained a severe genital ulcer.She had a purulent oozing and stinky ulceration on the right side of labium minor measuring 5-8 cm.

View Article: PubMed Central - PubMed

Affiliation: Afyon Kocatepe University Department of Dermatology, Afyon, Turkey.

ABSTRACT
Behçet's disease (BD), first described by Hulusi Behcet, is a multisystemic disease characterized by recurrent oral and genital ulcerations, ocular and cutaneous lesions, arthritis and vascular disease. Pyoderma gangrenosum (PG) is a rare, chronic, sterile pustular and progressive ulcerative process of unknown cause; sometimes can participate in the differential diagnosis of Behcet's ulceration. A 33-year-old woman complained a severe genital ulcer. She had a purulent oozing and stinky ulceration on the right side of labium minor measuring 5-8 cm. A punch biopsy at ulcer margin showed that the lymphocytic panniculitis was extending to the subcutaneous fat tissue without fibrin deposition or necrotic changes in the vessel wall. Based on the clinical and histological findings, she was diagnosed as genital ulcerative PG, which occurred during the exacerbation of BD.

No MeSH data available.


Related in: MedlinePlus