坏疽性脓皮病(PG)是一种罕见的嗜中性皮肤病,其特征是快速发展和疼痛的皮肤溃疡,具有独特的特征。就我们而言,东亚以前没有面部PG的病例报告.在这种情况下,我们描述了一例79岁的男性,他的脸颊和上唇有3个月的进行性疼痛性溃疡病史。最初怀疑非典型分枝杆菌感染导致治疗方案无效。综合感染检测结果呈阴性,pathergy测试阳性提示PG的潜在诊断。皮肤活检证实了诊断,静脉注射甲基强的松龙和口服环孢素治疗后,患者显着改善。三个月后,病变完全消退,无复发.该案例突出了与PG相关的诊断挑战,由于与其他条件相似,经常被误诊。彻底的评估对于排除替代诊断至关重要,尤其是皮肤感染。临床形态学,组织活检,和文化对于准确诊断至关重要。Pathergy的存在,轻微创伤后新病变的发展,也可以是诊断线索。
Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly developing and painful skin ulcers with distinctive features. As far as we are concerned, there is no previous case report on facial PG in East-Asia. In this case, we describe a case of a 79-year-old man with a 3-month history of progressive painful ulcers on his cheek and upper lip. Initial suspicion of atypical mycobacterium infection led to an ineffective treatment regimen. Comprehensive infectious testing yielded negative results, and a positive pathergy test indicated a potential diagnosis of PG. A skin biopsy confirmed the diagnosis, and the patient showed significant improvement with intravenous methylprednisolone and oral cyclosporine treatment. After three months, complete resolution of the lesions was achieved without recurrence. The case highlights the diagnostic challenges associated with PG, which is often misdiagnosed due to its resemblance to other conditions. Thorough evaluation is crucial to exclude alternative diagnoses, particularly cutaneous infections. Clinical morphology, tissue biopsy, and culture are essential for accurate diagnosis. The presence of pathergy, the development of new lesions following minor trauma, can also be a diagnostic clue.