Abstract
A 71-year-old woman was admitted to the department of internal medicine with chief complaints of hematochezia, abdominal pain and fever, with a body temperature of approximately 39°C. A diagnosis of left-sided ulcerative colitis was made using colonoscopy. Thereafter, a pustule appeared on the right gluteal region and formed a painful ulcer. Based on the histopathological findings and clinical symptoms, we diagnosed the ulcer as a complication of pyoderma gangrenosum. Treatment of the ulcerative colitis with steroid administration elicited no improvement, and the pyoderma gangrenosum proved to be refractory. Thus, we performed a granulocyte apheresis procedure, after which both conditions improved quickly. We believe that leukocytapheresis is a valuable treatment when performed aggressively in cases of steroid-resistant pyoderma gangrenosum or to quickly taper steroid dosage. At present, leukocytapheresis for isolated pyoderma gangrenosum is not covered by insurance, but we hope that coverage will be expanded to include the treatment hereafter.Skin Research, 16: 150-154, 2017
