PYODERMA-GANGRENOSUM IN INFLAMMATORY BOWEL-DISEASE
PYODERMA-GANGRENOSUM IN INFLAMMATORY BOWEL-DISEASE
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DOI：
10.1002/bjs.1800780613
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发表时间：
1991-06-01
影响因子：
9.6
通讯作者：
PHILLIPS, RKS
中科院分区：
文献类型：
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作者：
LEVITT, MD;RITCHIE, JK;PHILLIPS, RKS
自1954年以来，有34名患者参加了圣马克医院与坏疽性脓疡与溃疡性结肠炎（22例）或克罗恩病（12例）。 71%的病变是多发性的，一半以上位于膝盖以下。 溃疡性结肠炎是活跃的11例（50%）和克罗恩病是活跃的9例（75%）时，坏疽性化脓性脓疡被诊断。 相关疾病-最常见的是影响大关节的血清阴性关节炎-分别出现在55%和92%的病例中。 6例患者出现弥漫性脓疱性皮疹，5例同时出现脓毒症。 在另外7例患者（2例溃疡性结肠炎，5例克罗恩病）中，脓毒症的发作或病程可能与非皮肤化脓有关。 三分之二的患者在没有肠切除的情况下脓皮病消退。 在手术切除时（13例患者进行了15次手术），6例患者的化脓性溃疡迅速愈合，4例患者仅接受了额外治疗，5例患者愈合非常缓慢或根本没有愈合。 坏疽性脓皮病发生在溃疡性结肠炎和克罗恩病中。 肠切除术后的愈合在切除的时间和范围方面都是不可预测的。
Since 1954, 34 patients have attended St. Mark's Hospital with pyoderma gangrenosum in association either with ulcerative colitis (22 patients) or Crohn's disease (12 patients). Lesions were multiple in 71 per cent and over half were situated below the knees. Ulcerative colitis was active in 11 patients (50 per cent) and Crohn's disease was active in nine (75 per cent) when pyoderma gangrenosum was diagnosed. Associated illnesses - most commonly a seronegative arthritis affecting large joints - were present in 55 per cent and 92 per cent of cases respectively. A diffuse pustular rash appeared in six patients, synchronously with pyoderma in five. In a further seven patients (two with ulcerative colitis, five with Crohn's disease) the onset or course of pyoderma might have been linked to the presence of non-dermatological suppuration. Pyoderma resolved without intestinal resection in two-thirds of patients. When present at the time of surgical resection (15 procedures in 13 patients), pyoderma healed promptly in six cases, only with additional therapy in four cases and very slowly or not at all in five cases. Pyoderma gangrenosum occurs in both ulcerative colitis and Crohn's disease. Healing after intestinal resection is unpredictable both with respect to timing and extent of resection.