Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Pyoderma Gangrenosum in a Patient with Ulcerative Colitis: A Case Report

궤양성 대장염에서 다발성으로 발생된 괴저농피증 1예

  • Kang, Kyoung-In (Department of Pediatircs, and Reconstructive Surgery, Chungnam National University College of Medicine) ;
  • You, Sun-Young (Department of Pediatircs, and Reconstructive Surgery, Chungnam National University College of Medicine) ;
  • Oh, Sang-Ha (Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine) ;
  • Kim, Jae-Young (Department of Pediatircs, and Reconstructive Surgery, Chungnam National University College of Medicine)
  • 강경인 (충남대학교 의학전문대학원 소아청소년과) ;
  • 유선영 (충남대학교 의학전문대학원 소아청소년과) ;
  • 오상하 (충남대학교 의학전문대학원 성형외과) ;
  • 김재영 (충남대학교 의학전문대학원 소아청소년과)
  • Received : 2009.08.04
  • Accepted : 2009.09.14
  • Published : 2009.09.30
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Abstract

Pyoderma gangrenosum associated with ulcerative colitis is an unknown etiology of destructive skin disorder, characterized by progressive painful ulceration. It begins as a erythematous areola or pustule and rapidly progress into a deep ulceration with a discrete and violaceous edge. Early diagnosis followed with non-compressive moist dressing, topical application and systemic immunosuppressants are cornerstone in treating this disease. We report a case of pyoderma gangrenosum exacerbated with incision and drainage in a 15 year old girl with ulcerative colitis. This case emphasizes the importance of early consideration of pyoderma gangrenosum in patient with a background of related systemic disease and minimal traumatized wound care.

만성 염증성 장 질환에서 유발되는 드문 피부 병변인 괴저 농피증은 초기에는 홍반으로 둘러싸인 농포로 시작하지만 빠르게 주변부로 확장되고 염증이 진피 내로 파급 되면서 깊은 궤양이 생겨 피부 함몰을 일으킨다. 초기에 감염성 연부조직염 등으로 오인하여 절개 배농이나 강한 압박 배농을 하게 되면 이 질환의 이상초과민현상 때문에 병변이 악화되는 경향이 있다. 따라서 조기 진단과 습윤-비밀폐 드레싱으로 상처에 가하는 충격을 최소화하면서 상처 부위를 보존하고 2차 세균 감염을 예방하는 것이 초기 치료에 매우 중요하다. 저자들은 궤양성 대장염을 가진 15세 여자에서 발생한 괴저 농피증을 초기 에 압박 배농하여 병변이 빠르게 악화된 증례의 치료 경험을 보고하면서 조기 진단과 초기 치료 대응의 중요성을 강조하고자 한다.

Keywords

References

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