Pioderma Gangrenosum. A propósito de un caso clínico

Resumen

El Pioderma Gangrenosum es una enfermedad poco frecuente de etiología no definida, caracterizada por lesiones cutáneas ulcerativas, destructivas, de curso crónico y recurrente con características clínicas particulares y generalmente asociada a patologías subyacentes. Presentamos un caso de una mujer de 29 años, con diagnóstico de Rectocolitis Ulcerosa de seis años de evolución, quien presentó lesiones en ambas piernas nodulares, eritematosas, dolorosas que posteriormente se hicieron fluctuantes, ulcerándose, con bordes bien definidos, elevados, de coloración eritematoviolacea, con secreción achocolatada espesa en moderada cantidad, no fétida que aumentaron progresivamente de tamaño, rodeandose de pequeñas pustulas. Se realizaron cultivos y biopsia de la lesión encontrando hallazgos compatibles con Pioderma Gangrenosum. Recibió tratamiento con metilprednisolona y luego prednisona oral con evolución satisfactoria. Conclusión: el Pioderma Gangrenosum es una manifestacion extraintestinal cutánea de la enfermedad inflamatoria intestinal asociado o no a la actividad de la misma y que actualmente no cuenta con un tratamiento especifico

Abstract
Pyoderma gangrenosum is an uncommon disease of uncertain etiology, featuring ulcerative, destructive and painful cutaneous injuries, with chronic and relapsing course and particular clinical features, usually associated to underlying pathologies. A case of a 29 years old female with diagnosis of ulcerous rectocolitis of six years of evolution is reported, who presented nodular, erythematous, painful injuries in both legs that futher became fluctuating and ulcerous, shallow, with well -defined borders, raised, erythematoviolaceous colored, with moderate amounts of chocolaty thick non-fetid secretion, increasing their size progressively, being surrounded by small pustules. Culture and biopsy of the injury were performed, showing compatibility to Pyoderma Gangrenosum. The patient was treated with intravenous bolus of methylprednisolone and later oral prednisone, evolving satisfactorily. Conclusion: Pyoderma Gangrenosum is one of the extraintestinal cutaneous manifestations of the inflammatory bowel disease whether associated or not to its activity, and currently has not a specific treatment, with corticosteroids being one of the most effective drugs.