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Mohammad Javad Yazdanpanah , Zohreh Yousefi , Amir Hosein Jafarian , Laya Shirinzadeh , Mina Baradaran ,
Volume 75, Issue 6 (9-2017)
Abstract

Background: Pyoderma gangrenosum (PG) (ulcerating neutrophilic dermatosis) is a rare disease that about of half of these patients have a systemic disorder, particularly Crohn's and ulcerative colitis. In addition, inflammatory lesions play key role in its pathogenesis. In early diagnosis of disease, we will further prevent of serious consequences of the disease. In this report, a case of PG after the vaginal surgery with history of ulcerative colitis was introduced.
Case presentation: A 37-years old woman was admitted in an University Hospital of Mashhad University of Medical Sciences, Iran, in 2016 two weeks after genital surgery. The chief complaints were fever, painful tenderness, ulcerative lesion and inflammatory papule on surgical site and thigh. She suffered of fever despite received oral and then wide spectrum intravenous antibiotic therapy. Blood cultures and wound culture were negative. In addition to two deferent intravenous antibiotics, topical wound debridement was performed. Despite this course of treatment which did not improve the lesion, biopsy was performed. Histopathology features of biopsy specimen indicated prominent neutrophils mixed inflammation and lymphocytic vasculitis indicated as pyoderma gangrenous. The patient's medical history included associated ulcerative colitis from 18 years ago and she was under irregular oral receiving of Asacol (mesalamine). Intravenous corticosteroid therapy was administered which led to response of skin of right thigh and surgical site inflammation. After 6-months follow-up, the patient is still in good condition.
Conclusion: Based on major variable clinical manifestations and no diagnostic serologic test of pyoderma gangrenosum, diagnosis of this disease is difficult. Increased awareness about PG and exclusion of other etiologies such as inflammatory and immunologic disease will aid in prompting of pyoderma gangrenosum diagnosis and proper management of the disease.

Hamideh Molaei, Eghlim Nemati , Ehsan Shojaeefar , Leila Khedmat,
Volume 79, Issue 9 (12-2021)
Abstract

Background: Immunosuppressive drugs that are widely used to prevent acute and chronic organ rejections, predispose organ transplant patients to a variety of diseases including skin problems. This study aimed to determine the prevalence of skin lesions and to investigate their association with demographic characteristics in renal transplant patients.
Methods: This cross-sectional study was performed on 100 patients who were referred to the nephrology clinic of Baqiyatallah Hospital, Tehran, Iran and underwent kidney transplantation within a year (from the first working day of the Iranian Hijri calendar in April 2015 until the last working day in March 2016). Patients were referred to a dermatologist in case of any skin lesions. Patients' data were collected in a researcher-made questionnaire and were analyzed using SPSS software, version 18. The p values less than 5% were considered to be significant.
Results: The mean and standard deviation (SD) of the patients' age was 50/4±11/8 years.  The average time of incidence of skin lesion after transplantation has been 8/1 ± 5/7 weeks. The most common types of non-melanoma cancers were squamous cell carcinoma (2%) and Kaposi's sarcoma (4%) and there was no significant difference between men and women (p>0.05). Sixty-six percent of the patients had skin infections and the most common skin infections were wart (34%) and tinea versicolor (11%). The relative frequency of skin infections was significantly higher in male patients than in females (p=0.004). Considering all other confounding variables including smoking, hypertension, diabetes and other infectious diseases, the only noteworthy finding was the higher relative frequency of tinea versicolor in diabetic compared with non-diabetic patients (p=0.046).
Conclusion: This study showed that skin complications including various neoplastic (Sarcoma and Carcinoma), infectious (fungal and viral), and other (Acne and Hypertrichosis) diseases are common in patients with kidney transplantation who are taking immunosuppressive drugs. Informing these patients and medical staff about skin problems leads to an early referral of patients and increases their life expectancy and improves their quality of life.
 


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