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Cureus Mar 2024Pyoderma gangrenosum (PG) and erythema nodosum (EN) are rare skin conditions associated with inflammatory bowel disease (IBD), with increasing incidence as the disease...
Pyoderma gangrenosum (PG) and erythema nodosum (EN) are rare skin conditions associated with inflammatory bowel disease (IBD), with increasing incidence as the disease progresses. We describe three cases of newly diagnosed IBD with cutaneous extraintestinal manifestations (EIMs) at the time of diagnosis. Three previously healthy patients presented with bloody diarrhea and concomitant nodular and ulcerating skin lesions at the onset of diarrhea. Dermatopathology showed PG and EN with endoscopic confirmation of ulcerative colitis. Clinical improvement was achieved with steroids and biological agents. These cases display the importance of a proper review of symptoms and a detailed workup of dermatological lesions prior to assuming infectious etiology.
PubMed: 38576673
DOI: 10.7759/cureus.55548 -
Frontiers in Immunology 2024is a Gram-positive pathogen that causes a significant global burden of skin pyoderma and pharyngitis. In some cases, infection can lead to severe invasive streptococcal...
INTRODUCTION
is a Gram-positive pathogen that causes a significant global burden of skin pyoderma and pharyngitis. In some cases, infection can lead to severe invasive streptococcal diseases. Previous studies have shown that IL-17 deficiency in mice (IL-17) can reduce clearance from the mucosal surfaces. However, the effect of IL-17 on the development of severe invasive streptococcal disease has not yet been assessed.
METHODS
Here, we modeled single or repeated non-lethal intranasal (IN) M1 strain infections in immunocompetent and IL-17 mice to assess bacterial colonization following a final IN or skin challenge.
RESULTS
Immunocompetent mice that received a single infection showed long-lasting immunity to subsequent IN infection, and no bacteria were detected in the lymph nodes or spleens. However, in the absence of IL-17, a single IN infection resulted in dissemination of to the lymphoid organs, which was accentuated by repeated IN infections. In contrast to what was observed in the respiratory mucosa, skin immunity did not correlate with the systemic levels of IL-17. Instead, it was found to be associated with the activation of germinal center responses and accumulation of neutrophils in the spleen.
DISCUSSION
Our results demonstrated that IL-17 plays a critical role in preventing invasive disease following infection of the respiratory tract.
Topics: Animals; Mice; Interleukin-17; Monitoring, Immunologic; Respiratory Mucosa; Streptococcal Infections; Streptococcus pyogenes
PubMed: 38576622
DOI: 10.3389/fimmu.2024.1351777 -
The Journal of Allergy and Clinical... May 2024Leukocyte adhesion deficiency type 1 (LAD-1) is a congenital immunodeficiency leading to impaired trafficking of neutrophils to inflammation sites. Solitary or multiple...
BACKGROUND
Leukocyte adhesion deficiency type 1 (LAD-1) is a congenital immunodeficiency leading to impaired trafficking of neutrophils to inflammation sites. Solitary or multiple pyoderma gangrenosum (PG)-like skin ulcers (PGLUs) have been reported previously in 13 children (aged 0.5-19 years) with LAD-1.
OBJECTIVE
Our aim was to report the case of a 10-year-old boy presenting with PGLUs as the first manifestation of LAD-1 treated with ustekinumab.
METHODS
We obtained cytokine profiles.
RESULTS
PGLUs were triggered by cutaneous ringworm infection (). Skin biopsy samples showed increased intralesional expression of IL-17A, Il-23, and IL-1β as compared with their expression in healthy controls. After an unsuccessful attempt at treatment with oral methylprednisolone, ustekinumab induced regression of the ulcerations, associated with complete normalization of the cytokine profile.
CONCLUSIONS
PGLUs, triggered by ringworm infection, can be a late harbinger of LAD-1. Ustekinumab is a safe and effective therapeutic option for patients with LAD-1 and PGLUs while bridging the time until stem cell transplantation.
PubMed: 38560722
DOI: 10.1016/j.jacig.2024.100233 -
Journal of Orthopaedic Case Reports Mar 2024Pyoderma gangrenosum (PG) following a primary total knee arthroplasty (TKA) surgery is extremely rare, with very few cases reported in the literature.
INTRODUCTION
Pyoderma gangrenosum (PG) following a primary total knee arthroplasty (TKA) surgery is extremely rare, with very few cases reported in the literature.
CASE REPORT
We report our clinical experience of a 65-year-old female who developed PG following a primary TKA surgery. Corticosteroids and local wound care with vacuum-assisted closure dressing helped achieve rapid improvement in the wound condition.
CONCLUSION
Post-surgical PG in TKA can be challenging with limited evidence for its definitive treatment. A high degree of suspicion and a multidisciplinary management approach will help in the timely diagnosis and optimization of treatment for this condition.
PubMed: 38560315
DOI: 10.13107/jocr.2024.v14.i03.4334 -
Acta Dermato-venereologica Mar 2024
Review
Topics: Male; Humans; Pyoderma Gangrenosum; Penis; Sexually Transmitted Diseases
PubMed: 38551377
DOI: 10.2340/actadv.v104.32160 -
Veterinary Journal (London, England :... Apr 2024Staphylococcus pseudintermedius is the most common cause of pyoderma in dogs. We validated a point-of-care (PoC) test based on colorimetric loop-mediated isothermal...
Staphylococcus pseudintermedius is the most common cause of pyoderma in dogs. We validated a point-of-care (PoC) test based on colorimetric loop-mediated isothermal amplification (LAMP) for rapid S. pseudintermedius identification and susceptibility testing for first line antimicrobials for systemic treatment of canine pyoderma, i.e., lincosamides, first generation cephalosporins and amoxicillin clavulanate. Newly designed LAMP primers targeting clinically relevant resistance genes were combined with a previously validated set of primers targeting spsL for species identification. After laboratory validation on 110 clinical isolates, we assessed the performance of the test on 101 clinical specimens using routine culture and susceptibility testing as a reference standard. The average hands-on and turnaround times for the PoC test were 30 and 90 min, respectively. The assay showed sensitivity and specificity near 100% for both species identification and susceptibility testing when performed on bacterial cultures or clinical specimens in the laboratory. However, the PoC test yielded less accurate results when performed on-site by clinical staff (92% sensitivity and 64% specificity for species identification, 67% sensitivity and 96% specificity for β-lactam susceptibility, and 83% sensitivity and 71% specificity for lincosamide susceptibility). These results indicate that the PoC test should be adapted to a user-friendly technology to facilitate performance and interpretation of results by clinical staff. If properly developed, the test would allow veterinarians to gain rapid information on antimicrobial choice, limiting the risk of treatment failure and facilitating adherence to antimicrobial use guidelines in small animal veterinary dermatology.
Topics: Dogs; Animals; Anti-Bacterial Agents; Staphylococcus; Pyoderma; Anti-Infective Agents; Microbial Sensitivity Tests; Dog Diseases; Staphylococcal Infections
PubMed: 38547963
DOI: 10.1016/j.tvjl.2024.106105 -
Urology Case Reports May 2024Post-operative pyoderma gangrenosum is a rare neutrophilic dermatosis which forms within skin wounds following surgery. This condition is not well recognised, can be...
Post-operative pyoderma gangrenosum is a rare neutrophilic dermatosis which forms within skin wounds following surgery. This condition is not well recognised, can be difficult to diagnose and often mimics necrotising fasciitis. While wound exploration and debridement remains the standard of care in post-operative wound infection, this can paradoxically exacerbate pyoderma gangrenosum resulting in further morbidity and mortality. As such, surgeons that encounter post-operative pyoderma gangrenosum face a diagnostic dilemma. Here we present a 65 year old gentleman who developed pyoderma gangrenosum following open radical prostatectomy. We reflect on his management and discuss the pertinent points learned from this case.
PubMed: 38545250
DOI: 10.1016/j.eucr.2024.102709 -
Pharmaceuticals (Basel, Switzerland) Feb 2024() is the main pathogen causing pyoderma of canines. With the emergence of drug-resistant bacteria, traditional antibiotic treatments are limited. As a potential...
() is the main pathogen causing pyoderma of canines. With the emergence of drug-resistant bacteria, traditional antibiotic treatments are limited. As a potential antibacterial agent, NZ2114 was effective against , including drug-resistant strains. Its bactericidal efficacy was superior to mupiroxacin, ofloxacin and lincomycin. To facilitate the transcutaneous delivery of NZ2114 for the treatment of superficial pyoderma, chemical permeation enhancers were added since water-soluble NZ2114 does not easily penetrate the skin lipid layer. Two different NZ2114 sprays were prepared by combining 1% Azone + 10% propylene glycol (PG) or 5% N-methylpyrrolidone (NMP) + 10% PG with NZ2114 after screening. The cumulative permeability of NZ2114 sprays were 244.149 and 405.245 μg/cm at 24 h with an in vitro percutaneous assay of mice skin, which showed a 244% and 405% increase in skin permeability than NZ2114, respectively. In addition, the efficacy of NZ2114 sprays in reducing skin bacteria colonisation was demonstrated in a mouse model of superficial pyoderma (24 mice, 3 mice/group) induced by , and the 5% NMP + 10% PG + NZ2114 group had the best therapeutic effect compared to the other groups. This preparation did not cause any skin irritation, laying the foundation for the development of an effective and non-toxic topical product.
PubMed: 38543066
DOI: 10.3390/ph17030277 -
The American Journal of Case Reports Mar 2024BACKGROUND Pyoderma gangrenosum (PG) is a neutrophilic inflammatory disease associated with inflammatory and autoimmune conditions and malignancies. Previously...
BACKGROUND Pyoderma gangrenosum (PG) is a neutrophilic inflammatory disease associated with inflammatory and autoimmune conditions and malignancies. Previously identified links between PG and cancer have included hematological malignancies, solid-organ tumors such as gastric adenocarcinoma, and breast cancer. While specific histologic subtypes of breast cancer such as ductal carcinoma have been associated with PG of the extremities, the literature is limited on the association between PG and cutaneous metastatic lobular carcinoma. CASE REPORT We describe the case of an 84-year-old woman with recurrent cutaneous metastatic lobular carcinoma of the left anterior chest with concurrent pyoderma gangrenosum on her bilateral lower extremities. The patient was initially diagnosed with lobular carcinoma of the breast and underwent a left breast mastectomy and was in remission. One year later, she developed 2 lower-extremity ulcerations, which at the time were attributed to an injury and underlying venous stasis. She was referred to a wound care clinic, where the lesions worsened with surgical debridement. Six years later, she presented to the dermatology clinic with a rash on her chest wall and worsening of the ulcerations on her ankles bilaterally. Biopsies revealed lobular carcinoma metastatic to the skin of her anterior chest wall and histopathology consistent with pyoderma gangrenosum on her ankles. CONCLUSIONS This case demonstrates a unique presentation of worsening pyoderma gangrenosum due to metastatic malignancy in conjunction with a cutaneous manifestation of lobular carcinoma.
Topics: Female; Humans; Aged, 80 and over; Pyoderma Gangrenosum; Breast Neoplasms; Carcinoma, Lobular; Mastectomy; Neoplasm Recurrence, Local
PubMed: 38531543
DOI: 10.12659/AJCR.942488 -
SAGE Open Medical Case Reports 2024Pyoderma gangrenosum is a rare inflammatory neutrophilic disorder with no uniformly effective therapy and limited high-level evidence. Common therapies include...
Pyoderma gangrenosum is a rare inflammatory neutrophilic disorder with no uniformly effective therapy and limited high-level evidence. Common therapies include immunosuppressive and immunomodulating agents. There exist several case series using small molecules as treatment modalities. Here, we report a case of a 78-year-old female with a diagnosis of pyoderma gangrenosum and metastatic high-grade serous carcinoma of the ovary who was treated with Baricitinib 4 mg daily in combination with a tapering course of prednisone after failing other conventional therapies including systemic corticosteroids, colchicine, and intravenous immunoglobulin.
PubMed: 38524384
DOI: 10.1177/2050313X241235444