A 63-year-old man with chronic lymphocytic leukaemia developed pyodermagan grenosum following minortrauma to the leg. He required intensive inpatient management with a multitude of treatmentsincludinglarvaltherapy,sur...A 63-year-old man with chronic lymphocytic leukaemia developed pyodermagan grenosum following minortrauma to the leg. He required intensive inpatient management with a multitude of treatmentsincludinglarvaltherapy,surgicaldebridement,ciclosporin, methotrexate, thalidomide, pulsed intravenous methyl prednisolone and high-dose intravenous immunoglobulin, clofazamine and high dose oral corticosteroids, none of which were helpful. Treatment complications included steroid-induced diabetes, Cushing’ s syndrome and perforated peptic ulcer. The pyoderma remained refractory to treatment and continued to extend until he received intravenous infliximab 5 mg/kg at weeks 0, 2 and 6.展开更多
Mycobacterium szulgai is a nontuberculous, acid-fast bacillus or atypical mycobacteria, which prior to 1972 was not thought of as a pathogen.Since then most cases reported in the literature have been of pulmonary dise...Mycobacterium szulgai is a nontuberculous, acid-fast bacillus or atypical mycobacteria, which prior to 1972 was not thought of as a pathogen.Since then most cases reported in the literature have been of pulmonary disease with only a few case reports of cutaneous disease.Our patient, who had an underlying, uncategorized, immunosuppressive condition, presented with multiple severe ulcers spreading proximally up the arms in a sporotrichoid pattern with more scatttered lesions on his legs.He made a full recovery with appropriate antimicrobial treatment.展开更多
文摘A 63-year-old man with chronic lymphocytic leukaemia developed pyodermagan grenosum following minortrauma to the leg. He required intensive inpatient management with a multitude of treatmentsincludinglarvaltherapy,surgicaldebridement,ciclosporin, methotrexate, thalidomide, pulsed intravenous methyl prednisolone and high-dose intravenous immunoglobulin, clofazamine and high dose oral corticosteroids, none of which were helpful. Treatment complications included steroid-induced diabetes, Cushing’ s syndrome and perforated peptic ulcer. The pyoderma remained refractory to treatment and continued to extend until he received intravenous infliximab 5 mg/kg at weeks 0, 2 and 6.
文摘Mycobacterium szulgai is a nontuberculous, acid-fast bacillus or atypical mycobacteria, which prior to 1972 was not thought of as a pathogen.Since then most cases reported in the literature have been of pulmonary disease with only a few case reports of cutaneous disease.Our patient, who had an underlying, uncategorized, immunosuppressive condition, presented with multiple severe ulcers spreading proximally up the arms in a sporotrichoid pattern with more scatttered lesions on his legs.He made a full recovery with appropriate antimicrobial treatment.
