[Chronic vegetating pyodermia in cellular immune deficiency]

The simultaneous occurrence of pyoderma gangrenosum together with other diseases, most frequently ulcerative colitis, and with disorders of the humoral immune system is known. The etiology of the individual case remains nevertheless unclear in most instances. We report on an otherwise normal patient with normal immunoglobulin levels, who showed, by use of lymphocyte differentiation and functional tests, a nearly complete lack of T-cell reactivity. A substitution with transfusions of fresh blood lead to rapid healing of the clinical picture, which so far had been resistant to long term application of antibiotics, azathioprine and topical steroids. Therefore it is recommended to look for functional defects of the T-cell system as a cause of pyoderma gangrenosum.