Pyoderma gangrenosum, nadir görülen, ülserlerle karakterize, inflamatuvar bir deri hastaligidir. Lezyonlar, ülseratif kolit, Crohn hastaligi, monoklonal gammopati gibi sistemik hastaliklarla birlikte veya altta yatan hastalik olmaksizin tek basina görülebilir. Bu makalede ülseratif kolitin aktivite kazanmasi ile ortaya çikan yaygin pyoderma gangrenosum olgusunu sunduk. 21 yasinda erkek hasta, 1 aydir kanli mukuslu diskilama ile birlikte tüm vücutta yaygin ve siddetli agrili, bazilari pürülan ve akintili ülserler ve nekrotik yaralarla klinigimize basvurdu. Rektosigmoidoskopide aktif evre ülseratif kolit saptandi ve alinan biyopsilerle ülseratif kolit tanisi tekrar dogrulandi. Gaytanin mikroskopik incelemesi ile amibiazis ekarte edildi. Gram boyama ve kültür sonucu ile enfeksiyöz nedenler dislandiktan sonra klinik ve histopatolojik bulgularla pyoderma gangrenosum tanisi konuldu. Olguya pyoderma gangrenosum ve ülseratif kolit tanisiyla 80 mg/gün metilprednisolon baslandi. Semptom ve bulgular 10 günde büyük oranda, 3 haftada ise tamamen düzeldi. Sonuç olarak, ülseratif kolitte nadir olarak görülen ve genellikle hastalik aktivitesinden bagimsiz olarak seyreden pyoderma gangrenosum, hastaligin aktivitesi ile birlikte de ortaya çikabilmekte ve yüksek doz steroid tedavisiyle de kisa sürede iyilesebilmektedir.
Pyoderma gangrenosum is a rare inflammatory skin illness characterized by ulcers. It can be seen with unknown etiology or with some systemic disorders such as ulcerative colitis, Crohn’s disease and monoclonal gammopathy. Ulcers may be seen as single or multiple. We present in this article a pyoderma gangrenosum case that occurred with the activation of ulcerative colitis. A 21-year-old male was admitted to our hospital with a one-month history of symptoms of bloody and mucoid defecation with general intense body pain, ulcers (some with purulent secretion) and necrotic wounds. Rectosigmoidoscopy showed active state ulcerative colitis, and this diagnosis was confirmed with biopsies. Amebiasis was excluded with stool examination. After exclusion of infectious causes with gram staining and culture, the patient was diagnosed as pyoderma gangrenosum with histopathological findings. We started high-dose corticosteroid with the diagnosis of pyoderma gangrenosum and ulcerative colitis. Symptoms and findings significantly regressed in 10 days and totally healed in three months. In conclusion, pyoderma gangrenosum (which rarely occurs and usually does not correlate with the disease activity) can be seen with disease activity and may heal with high-dose steroid treatment in a short time.