一位71岁的男性患者，有5年糖皮质激素依赖性溃疡性结肠炎病史，因左胸、左腿快速进展的痛性溃疡（如图）就诊消化科。查体见左胸和左腿皮肤溃烂，基底部化脓和不规则紫色边缘。从胸部溃疡处取活检标本行组织病理学检查，结果显示表皮和真皮浅层坏死伴潜在的混合性炎性细胞浸润、脓肿形成及白细胞破裂性血管炎。微生物直接检测及培养细菌、真菌及非典型分枝杆菌病原体均阴性。诊断为坏疽性脓皮病。坏疽性脓皮病是一种溃疡性、炎性皮肤病变，可与潜在的系统性疾病相关（如溃疡性结肠炎）。该病是除结节性红斑以外，炎症性肠病在皮肤最常见的表现。患者接受英夫利昔单抗治疗，按0，2，6周给药，后改为每八周用药。3个月后，皮肤损害完全消退，溃疡性结肠炎缓解。
原文译自PerriconeG,VangeliM.PyodermaGangrenosuminUlcerativeColitis.NEnglJMed.Jul26;(4):e7.
A71-year-oldmanwitha5-yearhistoryofglucocorticoid-dependentulcerativecolitispresentedtothegastroenterologyclinicwithpainful,rapidlyprogressiveulcerativelesionsinvolvingtheleftchest(PanelA)andleg(PanelB).Thephysicalexaminationrevealedskinulcerationswithapurulentbaseandanirregularpurpleedge.Thehistopathologicalexaminationofanincisionalbiopsysampleobtainedfromthechestlesionshowedepidermalandsuperficialdermalnecrosiswithanunderlyingmixedinflammatory-cellinfiltrate,abscessformation,andleukocytoclasticvasculitis.Directmicrobiologicexaminationandcultureswerenegativeforbacterial,fungal,andatypicalmycobacterialpathogens.Adiagnosisofpyodermagangrenosumwasmade.Pyodermagangrenosumisanulcerating,inflammatoryskindisorderthatcanbeassociatedwithanunderlyingsystemicdisease,suchasulcerativecolitis.Theconditionisthesecondmost白癜风专家北京最专业的白癜风医院