PYODERMA GANGRENOSUM: CASE REPORT

Bolesnik u dobi od pedesetišest godina upućen je u Kliniku zbog pogoršanja fizikalnog nalaza rezistentnih ulceracija na desnoj nozi. u dva navrata histološki je potvrđena klinička sumnja na Pyoderma gangrenosum. Opsežnom obradom utvrđene su promjene na sluznici kolona te je i histološki potvrđena Crohnova bolest. Nakon terapije sistemskim kortikosteroidima te primjerene njege i liječenja ulceracija oblogama za vlažno cijeljenje rana došlo je do potpune epitelizacije svih ulceracija.A 56-year-old patient presenting necrotic ulcerations on the right leg was admitted to our Department for physical status deterioration. Clinically suspected diagnosis of pyoderma gangrenosum was confirmed histologically. Considering the association of pyoderma gangrenosum with several systemic diseases, extensive diagnostic evaluation was performed. Colonoscopy showed multiple ulcerations on descendent colon with stenosis of the shorter segment. Histologic examination confirmed the diagnosis of Crohn’s disease. After systemic treatment with corticosteroids and wound management with proper wound dressings, complete epithelialization of ulcerations was accomplished

PYODERMA GANGRENOSUM: CASE REPORT

Bolesnik u dobi od pedesetišest godina upućen je u Kliniku zbog pogoršanja fizikalnog nalaza rezistentnih ulceracija na desnoj nozi. u dva navrata histološki je potvrđena klinička sumnja na Pyoderma gangrenosum. Opsežnom obradom utvrđene su promjene na sluznici kolona te je i histološki potvrđena Crohnova bolest. Nakon terapije sistemskim kortikosteroidima te primjerene njege i liječenja ulceracija oblogama za vlažno cijeljenje rana došlo je do potpune epitelizacije svih ulceracija.A 56-year-old patient presenting necrotic ulcerations on the right leg was admitted to our Department for physical status deterioration. Clinically suspected diagnosis of pyoderma gangrenosum was confirmed histologically. Considering the association of pyoderma gangrenosum with several systemic diseases, extensive diagnostic evaluation was performed. Colonoscopy showed multiple ulcerations on descendent colon with stenosis of the shorter segment. Histologic examination confirmed the diagnosis of Crohn’s disease. After systemic treatment with corticosteroids and wound management with proper wound dressings, complete epithelialization of ulcerations was accomplished

Vitamin D supplementation in patients with atopic dermatitis, chronic urticaria and contact irritant and allergic dermatitis – possible improvement without risk

Abstract Introduction: There has been a lot of talk lately about the importance of reduced serum vitamin D levels and their supplementation for patients with inflammatory skin diseases such as atopic dermatitis (AD) and other allergic diseases. Serum vitamin D values are associated with a number of factors such as limited sunlight exposure (modern lifestyle, extended indoor stay, enhanced sun protection, etc.) which can affect different diseases. Aim: To evaluate serum vitamin D values in patients with inflammatory skin diseases, comparing them on the basis of other parameters (age, gender/sex, residential areas, total serum IgE), and establishing whether vitamin D supplementation would affect the improvement of the clinical picture of the disease. Patients and methods: A total of 157 patients participated in this prospective study: 51 patients with AD, 55 with chronic urticaria (CU) and 51 with contact dermatitis (CD): 38 with irritant CD (ICD) and 13 with allergic CD (ACD). In all patients, the values of serum vitamin D were determined by chemiluminescence microparticle immunoassay (CMIA) and compared by diagnosis, age, sex, living environment, values of total IgE. In patients with reduced values of vitamin D, its supplementation for 3 months was recommended, after which the second evaluation of D vitamin values and disease status were determined and compared with an untreated/unsupplemented group with normal vitamin D values. Results: Vitamin D deficiency was often observed in patients with AD, CU and CD, most frequently in the ICD group, and least frequently in the ACD group. No significant differences were found in terms of age, gender or living environment, nor was any correlation with total IgE found. In the subjects supplemented with vitamin D, their levels increased significantly and, after its supplementation, improvement of the clinical condition was more common than in the untreated group; however, the differences were not statistically significant (69.8 vs. 58.1, p=0.428). Conclusions: Although serum vitamin D levels of the groups did not differ significantly, the supplementation of vitamin D in patients with prominent vitamin D deficiency may be useful and crucial for improving the prognosis of the disease