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- W2065350400 abstract "Nous rapportons une observation originale de pyoderma gangrenosum dont les lésions présentaient en profondeur des aspects histologiques inhabituels d’infiltrat granulomateux dermo-hypodermique massif. La signification de cette particularité histologique est discutée. Une adolescente de 15 ans présentait depuis deux mois des ulcérations des deux jambes et du front. Elle avait aussi des douleurs abdominales avec vomissements et diarrhées. L’examen histologique révélait la présence de granulomes épithélioïdes et gigantocellulaires de siège profond dermo-hypodermique, avec présence d’un micro-abcès au sein du derme et au sein d’un granulome. Une tomodensitométrie abdomino-pelvienne montrait un épanchement péritonéal de moyenne abondance avec une formation tissulaire en situation latéro-cave. La colonoscopie était normale. L’évolution était favorable, cliniquement et radiologiquement, sous corticothérapie orale. La présence, à l’examen histologique, de granulomes profonds de siège dermo-hypodermique est inhabituelle au cours du pyoderma gangrenosum. En l’absence d’indice en faveur d’une cause infectieuse, et devant la bonne évolution sous corticothérapie orale, le premier diagnostic discuté était celui de maladie de Crohn. La normalité de la colonoscopie nous fait privilégier l’hypothèse d’une forme exceptionnelle de pyoderma gangrenosum granulomateux. We report an extremely rare case of pyoderma gangrenosum with the clinical features of pyoderma gangrenosum but with unusual histopathological findings and deep massive granulomatous infiltration through the dermis. A 15-year-old girl presented with a two-month history of deep ulcers on the lower legs and forehead. She also presented abdominal pain with diarrhea and vomiting that disappeared after symptomatic treatment. Histology showed extensive granulomatous infiltration in the dermis and hypodermis and a micro-abscess in the dermis. An abdominopelvic CT scan revealed peritoneal fluid and tissue formation in a lateral carotid cave (6.56 cm/4.56 cm). Colonoscopy was normal. The patient was treated with oral prednisone, resulting in resolution of the problems of cutaneous lesions, peritoneal fluid and tissue formation. Our case involves a rare presentation of pyoderma gangrenosum (PG) inconsistent with any of the four clinical variants of PG and characterized histologically by the presence of deep granulomas in the dermis and hypodermis. Despite the atypical clinical presentation and unusual histopathological findings, PG seemed the most likely diagnosis after infectious diseases had been ruled out; the good outcome achieved with oral corticosteroids supported our diagnosis." @default.
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- W2065350400 date "2015-05-01" @default.
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- W2065350400 title "Pyoderma gangrenosum granulomateux profond : une forme originale de pyoderma gangrenosum ?" @default.
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- W2065350400 doi "https://doi.org/10.1016/j.annder.2014.11.010" @default.
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