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Pyoderma gangrenosum and adrenocortical carcinoma
H G Cole1, R L Nelson, M S Peters
1Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905.
Cutis
|September 1, 1989
Summary
Pyoderma gangrenosum can be linked to systemic conditions. This case highlights a rare association with adrenocortical carcinoma, suggesting malignancy evaluation for patients with pyoderma gangrenosum.
Area of Science:
- Dermatology
- Oncology
- Endocrinology
Background:
- Pyoderma gangrenosum (PG) is a rare inflammatory ulcerative skin disease.
- Systemic associations of PG include inflammatory bowel disease, rheumatoid arthritis, paraproteinemias, and hematologic malignancies.
- Solid tumors are rarely associated with PG.
Observation:
- A 55-year-old woman presented with pyoderma gangrenosum, IgA monoclonal gammopathy, and a cortisol-secreting adrenocortical carcinoma.
- Literature review identified only one prior case of PG associated with a solid tumor.
Findings:
- The patient experienced rapid improvement in pyoderma gangrenosum following resection of the adrenocortical carcinoma.
- A disease-free course post-surgery suggests a direct relationship between the skin condition and the adrenal cancer.
Implications:
- This case underscores the importance of considering underlying malignancy in the differential diagnosis of pyoderma gangrenosum.
- Further investigation into the paraneoplastic potential of PG is warranted.
- Adrenocortical carcinoma should be considered in patients with refractory or atypical pyoderma gangrenosum.