Intest Res.  2018 Jan;16(1):155-157. 10.5217/ir.2018.16.1.155.

Hyperbaric oxygen therapy for pyoderma gangrenosum associated with ulcerative colitis

• Seo HI
• Lee HJ
• Han KH

• KMID: 2402661
• DOI: http://doi.org/10.5217/ir.2018.16.1.155

Abstract

Pyoderma gangrenosum (PG), an ulcerating skin condition, is rare in patients with ulcerative colitis (UC). We report a case of successful treatment of PG in a patient with UC using hyperbaric oxygen therapy (HBOT). The patient had UC that was in remission following treatment with mesalazine and azathioprine therapy. After visiting an orthopedic clinic, the patient opted for treatment with antibiotics and daily dressing of the ulcerative skin lesions, while azathioprine was discontinued. However, the lesions did not improve. Two months later, the patient visited a dermatologist who diagnosed the lesions as PG, and he was admitted to our unit. Surgical debridement and HBOT were performed by a plastic surgeon in the emergency department. After 3 months of HBOT and topical treatment, the patient's PG completely resolved. His UC was still in remission with mesalazine alone. HBOT may be an effective and safe alternative treatment for PG associated with UC, particularly in patients in whom anti-tumor necrosis factor agents are unnecessary.

Keyword

Pyoderma gangrenosum; Hyperbaric oxygenation; Colitis, ulcerative

MeSH Terms

Anti-Bacterial Agents
Azathioprine
Bandages
Colitis, Ulcerative*
Debridement
Emergency Service, Hospital
Humans
Hyperbaric Oxygenation*
Mesalamine
Necrosis
Orthopedics
Plastics
Pyoderma Gangrenosum*
Pyoderma*
Skin
Ulcer*
Anti-Bacterial Agents
Azathioprine
Mesalamine
Plastics

Figure

• 

  Fig. 1 (A) Photographs of both shins, showing ulcerative lesions with surrounding erythema. (B) Photographs of both shins after 3 months of hyperbaric oxygen therapy. Following ulcerative lesions resolution, only post-inflammatory hyperpigmentation remained.

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