Asunto(s)
Eritema/patología , Neoplasias Pulmonares/complicaciones , Micosis Fungoide/patología , Neoplasias Cutáneas/patología , Anciano , Complejo CD3/análisis , Antígenos CD4/análisis , Antígenos CD8/análisis , Diagnóstico Diferencial , Humanos , Antígenos Comunes de Leucocito/análisis , Linfocitos/química , Masculino , Micosis Fungoide/química , Micosis Fungoide/complicaciones , Micosis Fungoide/inmunología , Neoplasias Cutáneas/química , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/inmunologíaAsunto(s)
Celulitis (Flemón)/microbiología , Mycobacterium tuberculosis/aislamiento & purificación , Piel/microbiología , Tuberculosis Cutánea/microbiología , Anciano de 80 o más Años , Antituberculosos/uso terapéutico , Técnicas Bacteriológicas , Biopsia , Celulitis (Flemón)/diagnóstico , Celulitis (Flemón)/tratamiento farmacológico , Resultado Fatal , Humanos , Masculino , Piel/efectos de los fármacos , Piel/patología , Insuficiencia del Tratamiento , Tuberculosis Cutánea/complicaciones , Tuberculosis Cutánea/diagnóstico , Tuberculosis Cutánea/tratamiento farmacológicoAsunto(s)
Carcinoma de Células de Merkel/metabolismo , Carcinoma de Células Escamosas/metabolismo , Regulación Neoplásica de la Expresión Génica , Queratina-20/biosíntesis , Proteínas Nucleares/biosíntesis , Neoplasias Cutáneas/metabolismo , Factores de Transcripción/biosíntesis , Anciano de 80 o más Años , Carcinoma de Células de Merkel/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Citoplasma/metabolismo , Femenino , Humanos , Inmunohistoquímica/métodos , Oncología Médica/métodos , Neoplasias Cutáneas/diagnóstico , Factor Nuclear Tiroideo 1RESUMEN
A 51-year-old Japanese woman underwent subtotal colectomy for ulcerative colitis 5 years before her first visit to our hospital, and her symptoms stabilized. She presented with a 2-month history of proliferative, pustular lesions on her face, scalp, and gingival and anal mucosae. Histological examination showed features similar to those of pemphigus vegetans. However, the results of immunofluorescence studies, immunoblot analysis and enzyme-linked immunosorbent assay for pemphigus were negative, and colonoscopy revealed a relapse of ulcerative colitis in the remaining rectal mucosa, so a diagnosis of pyodermatitis-pyostomatitis vegetans was made. This is the first report of mucocutaneous lesions that developed with a relapse of ulcerative colitis in the remaining rectum after subtotal colectomy. Moreover, a close correlation was found between the condition of bowel inflammation and that of mucocutaneous lesions.
Asunto(s)
Colitis Ulcerosa/diagnóstico , Piodermia/diagnóstico , Estomatitis/diagnóstico , Azatioprina/uso terapéutico , Colectomía , Colitis Ulcerosa/patología , Colitis Ulcerosa/cirugía , Colonoscopía , Ciclosporina/uso terapéutico , Diagnóstico Diferencial , Femenino , Humanos , Mesalamina/uso terapéutico , Persona de Mediana Edad , Prednisolona/uso terapéutico , Piodermia/tratamiento farmacológico , Piodermia/patología , Recurrencia , Estomatitis/tratamiento farmacológico , Estomatitis/patología , Resultado del TratamientoRESUMEN
Our patient was a 37-year-old man with diabetes mellitus and hepatopathy as underlying diseases. Swelling, erythema and pain appeared in the left upper limb on the day before the initial examination. On examination, diffuse purpura was noted on the left upper limb, and, as it rapidly extended to the left upper trunk, emergency surgery was performed. Intraoperatively, gas-producing necrosis was observed not only in subcutaneous tissues but also from the fascia to muscle tissues, and the condition resembled clostridial gas gangrene. However, as the culturing of samples from the lesion yielded Bacillus cereus, a diagnosis of necrotizing fasciitis and myonecrosis (synergistic necrotizing cellulitis) due to B. cereus was made. While the patient developed a serious condition due to sepsis and disseminated intravascular coagulation, he could be saved by early debridement and intensive treatment with an appropriate selection of antibiotics.