Koebner Phenomenon in an ANCA‐Positive Patient with Pyoderma Gangrenosum

A male with pyoderma gangrenosum is reported. The clinical and histological features were typical. The initial lesions resolved with characteristic cribriform scars. A few days after the complete recovery, he developed several necrotizing focal lesions localized to the scarred areas. A further histo...

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Bibliographic Details
Published in:Journal of dermatology 1997-09, Vol.24 (9), p.583-586
Main Authors: Papi, Massimo, Didona, Biagio, Chinni, Luca Massimo, Gobello, Tommaso, Mazzanti, Cinzia, De Pità, Ornella, Cavalieri, Rino
Format: Article
Language:English
Subjects:
ANCA
Antibodies, Antineutrophil Cytoplasmic - blood
Humans
Koebner phenomenon
Male
Middle Aged
Necrosis
pyoderma gangrenosum
Pyoderma Gangrenosum - etiology
Pyoderma Gangrenosum - immunology
Pyoderma Gangrenosum - pathology
vascular neoformation
Vasculitis - etiology
Vasculitis - immunology
Vasculitis - pathology
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Summary:A male with pyoderma gangrenosum is reported. The clinical and histological features were typical. The initial lesions resolved with characteristic cribriform scars. A few days after the complete recovery, he developed several necrotizing focal lesions localized to the scarred areas. A further histological examination revealed a granulation tissue rich in neutrophils and signs of necrotizing vasculitis. We found a high titer of circulating perinuclear antineutrophil antibodies (p‐ANCA), which are a serological marker for various systemic diseases. An immunological circulating factor has been repeatedly suggested to be the “primum movens” of pyoderma gangrenosum. We discuss the unusual clinical presentation interpreted as a Koebner phenomenon and the possible role of immune factors in enhancing circulating‐endothelial cell interactions in relation to the pathogenesis of pyoderma gangrenosum.
ISSN:0385-2407
1346-8138
DOI:10.1111/j.1346-8138.1997.tb02297.x