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Pyoderma gangrenosum complicated with hematological malignancies: Two case reports
Fen Li1,2, Jie Zhao1,2, Huanan Duan1,2
1Department of Hematology, The First People's Hospital of Yunnan Province, Yunnan Province Clinical Research Center for Hematologic Disease, Yunnan Province Clinical Center for Hematologic Disease, Kunming, 650032 Yunnan, China.
Medicine
|March 8, 2024
Summary
Pyoderma gangrenosum (PG), a neutrophilic skin disease, can be linked to hematological malignancies. Early investigation of blood abnormalities is crucial for patients with characteristic PG skin lesions.
Area of Science:
- Dermatology
- Hematology
- Oncology
Background:
- Pyoderma gangrenosum (PG) is a rare, non-infectious neutrophilic dermatosis.
- Diagnosis relies heavily on clinical presentation, making characteristic features vital.
- Association with underlying systemic diseases, particularly hematological malignancies, is increasingly recognized.
Observation:
- Two young males presented with severe skin lesions consistent with PG.
- Both patients exhibited abnormal blood work and bone marrow biopsy findings indicative of hematological malignancies (CMML-0 and myeloid tumor).
- Initial treatment with hormones and antibiotics showed temporary improvement, but both cases had a poor prognosis.
Findings:
- Pyoderma gangrenosum can be a manifestation of underlying hematological malignancies.
- Neutrophilic infiltration and epidermal changes are key histopathological findings in PG.
- Bone marrow abnormalities, including abnormal cell proliferation and morphology, suggest a link to myeloid disorders.
Implications:
- Clinicians should consider investigating for hematological malignancies in patients presenting with typical pyoderma gangrenosum lesions and abnormal blood counts.
- This association highlights the importance of a multidisciplinary approach in managing complex dermatological conditions.
- Further research is warranted to elucidate the pathogenic mechanisms linking PG and hematological cancers.
