Abstract
We report on a 66-year-old female with pyoderma gangrenosum. Since 1984, she had suffered from systemic lupus erythematosus and antiphospholipid antibody syndrome. Some red nodules and ulcers appeared on both of her legs in November, 2005. The nodules were diagnosed as pyoderma gangrenosum by skin biopsy. She was treated with combination therapy of corticosteroid and cyclosporine, which improved the skin ulcers. She then developed “cellulitis” on her right thigh in June, 2006, which was improved by antibiotics, however, the ulcers on her legs exacerbated, and the patient was admitted to our hospital. After the hospitalization, we continued the combination therapy. Thereafter, thrombocytopenia appeared, and cytomegalovirus were detected in white blood cells. The small ulcers healed concomitantly with an increase in the number of platelets and decrease of cytomegalovirus-positive white blood cells. The skin ulcers of both legs and her general condition were stable from March, 2007 with 15mg of prednisolone daily, but she had abdominal distention and oliguria since the end of November, 2007. Her general condition then suddenly exacerbated, and on January, 2008, she passed away. After autopsy, the intestinal involvement was diagnosed as pseudomembranous colitis.
