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Pyoderma gangrenosum in refractory celiac disease: a case report
Silvia Sedda1, Roberta Caruso, Irene Marafini
1Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 1, 00133 Rome, Italy. Gi.Monteleone@Med.uniroma2.it.
BMC Gastroenterology
|November 28, 2013
Summary
This study details the first reported case of pyoderma gangrenosum in a patient with refractory celiac disease. Systemic steroids healed the skin lesions but did not improve the underlying celiac disease.
Area of Science:
- Dermatology
- Gastroenterology
- Immunology
Background:
- Pyoderma gangrenosum is a neutrophilic dermatosis causing painful skin ulcers.
- It is frequently linked to systemic inflammatory and neoplastic conditions.
- Refractory celiac disease (RCD) presents a diagnostic and therapeutic challenge.
Observation:
- A 52-year-old woman with RCD developed a rapidly progressing, painful skin lesion on her leg.
- Clinical examination revealed ulceration, necrosis, and purulent discharge.
- Histopathology and cytokine analysis confirmed pyoderma gangrenosum.
Findings:
- Treatment with oral prednisone led to complete healing of the pyoderma gangrenosum lesion.
- Steroid therapy did not resolve the malabsorption symptoms associated with RCD.
- This suggests distinct underlying mechanisms for RCD and pyoderma gangrenosum.
Implications:
- This case highlights a potential association between refractory celiac disease and pyoderma gangrenosum.
- It suggests that these conditions may have different immunological underpinnings.
- Further research is warranted to explore the relationship and potential therapeutic targets.
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