Nadir görülen bir ülseratif kolit komplikasyonu: Piyoderma

Pyoderma gangrenosum, nadir gorulen, ulserlerle karakterize, inflama- tuvar bir deri hastal›¤›d›r. Lezyonlar, ulseratif kolit, Crohn hastal›¤›, mo- noklonal gammopati gibi sistemik hastal›klarla birlikte veya altta yatan hastal›k olmaks›z›n tek bafl›na gorulebilir. Bu makalede ulseratif kolitin aktivite kazanmas› ile ortaya c›kan yayg›n pyoderma gangrenosum ol- gusunu sunduk. 21 yafl›nda erkek hasta, 1 ayd›r kanl› mukuslu d›flk›la- ma ile birlikte tum vucutta yayg›n ve fliddetli ar›l›, baz›lar› purulan ve ak›nt›l› ulserler ve nekrotik yaralarla kliniimize baflvurdu. Rektosigmo- idoskopide aktif evre ulseratif kolit saptand› ve al›nan biyopsilerle ulse- ratif kolit tan›s› tekrar doruland›. Gaytan›n mikroskopik incelemesi ile amibiazis ekarte edildi. Gram boyama ve kultur sonucu ile enfeksiyoz nedenler d›flland›ktan sonra klinik ve histopatolojik bulgularla pyoder- ma gangrenosum tan›s› konuldu. Olguya pyoderma gangrenosum ve ulseratif kolit tan›s›yla 80 mg/gun metilprednisolon baflland›. Semptom ve bulgular 10 gunde buyuk oranda, 3 haftada ise tamamen duzeldi. Sonuc olarak, ulseratif kolitte nadir olarak gorulen ve genellikle hasta- l›k aktivitesinden ba¤›ms›z olarak seyreden pyoderma gangrenosum, hastal›¤›n aktivitesi ile birlikte de ortaya c›kabilmekte ve yuksek doz steroid tedavisiyle de k›sa surede iyileflebilmektedir. Anahtar kelimeler: Ulseratif kolit, Pyoderma Gangrenosum, kortikos- teroid Pyoderma gangrenosum is a rare inflammatory skin illness characteri- zed by ulcers. It can be seen with unknown etiology or with some systemic disorders such as ulcerative colitis, Crohn's disease and mo- noclonal gammopathy. Ulcers may be seen as single or multiple. We present in this article a pyoderma gangrenosum case that occurred with the activation of ulcerative colitis. A 21-year-old male was admit- ted to our hospital with a one-month history of symptoms of bloody and mucoid defecation with general intense body pain, ulcers (some with purulent secretion) and necrotic wounds. Rectosigmoidoscopy showed active state ulcerative colitis, and this diagnosis was confir- med with biopsies. Amebiasis was excluded with stool examination. After exclusion of infectious causes with gram staining and culture, the patient was diagnosed as pyoderma gangrenosum with histopat- hological findings. We started high-dose corticosteroid with the diag- nosis of pyoderma gangrenosum and ulcerative colitis. Symptoms and findings significantly regressed in 10 days and totally healed in three months. In conclusion, pyoderma gangrenosum (which rarely occurs and usually does not correlate with the disease activity) can be seen with disease activity and may heal with high-dose steroid treatment in a short time.