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Periungual lesions in pyoderma gangrenosum
1Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland. adi_medicalis@go2.pl
Clinical and Experimental Dermatology
|May 15, 2009
Summary
Pyoderma gangrenosum (PG) can manifest as painful periungual lesions, particularly during immunosuppressive therapy tapering. Increasing ciclosporin A dosage effectively resolved these ulcerative lesions in a reported case.
Area of Science:
- Dermatology
- Immunosuppression
Background:
- Pyoderma gangrenosum (PG) is a rare, ulcerative skin condition of unknown etiology.
- Ciclosporin A is an immunosuppressive drug used in managing PG.
- Therapeutic adjustments in immunosuppression can impact disease activity.
Observation:
- A 57-year-old woman with PG experienced new, painful periungual ulcerative lesions during a dose reduction of ciclosporin A.
- Lesions developed rapidly on fingers and toes, affecting the nail folds.
- Skin biopsy confirmed findings consistent with pyoderma gangrenosum.
Findings:
- Periungual lesions represent an unusual presentation of pyoderma gangrenosum.
- Tapering ciclosporin A therapy was temporally associated with the onset of these lesions.
- Histopathological examination confirmed the diagnosis of PG.
Implications:
- This case highlights the importance of monitoring for atypical presentations of PG during immunosuppressive therapy adjustments.
- Re-escalation of ciclosporin A therapy demonstrated efficacy in treating these specific periungual lesions.
- Understanding drug-induced or therapy-related PG exacerbations is crucial for patient management.
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