Pyoderma VegetansVasculitis
Pyoderma Vegetans and Vasculitis are other rare skin disorders, believed to be due to abnormal immune system activity. Pyoderma vegetans, which affects people with ulcerative colitis, appears as blisters, plaques, or patches around the groin and under the arms. These become darkened areas of skin as they heal. Vasculitis, which means "inflammation of the blood vessels," is marked by raised reddened areas, sometimes ulcerous. Treatment of both these disorders centers around the IBD itself.
Hallopeau first characterized this process in 1898 (Hallopeau, 1898). Although its etiology is unknown, this disease has been attributed to bacterial infection in an individual who is immunocompromised (Brown, 1957); more recent reports support this theory (Su, 1979; Welch, 1989; Rongioletti, 1996). PV has been associated with ulcerative colitis (Brunsting, 1949), diffuse T-cell lymphoma (Welch, 1989), alcoholism with malnutrition (Brown, 1957), HIV infection (Potekaev, 1991), and chronic myeloid leukemia (CML) (Dutta, 1992).
Su et al reported 7 patients with clinically characteristic PV (Su, 1979). These patients had various conditions that compromised their immune systems; these conditions included pulmonary granuloma, chronic granulocytic leukemia, arthritis treated with azathioprine and prednisone, and seminoma treated with x-ray irradiation, which predisposed them to bacterial infections (Su, 1979). After PV was diagnosed, 1 patient developed squamous cell carcinoma and colonic carcinoma. Ishibashi described a patient with PV without any history of an immunocompromising condition (Ishibashi, 1986).
The etiology of PV is not known. An immunosuppressive state or a dysfunction of the immune system is believed to cause the development of vegetations. Diffuse T-cell lymphoma (Welch, 1989), ulcerative colitis (Brunsting, 1949), and HIV infection (Potekaev, 1991) have been associated with this condition.
Frequency:Rare
Vasculitis
Vasculitis” is a general term for a group of diseases that involve inflammation in blood vessels. Blood vessels of all sizes may be affected, from the largest vessel in the body (the aorta) to the smallest blood vessels in the skin (capillaries). The size of blood vessel affected varies according to the specific type of vasculitis. When blood vessels become inflamed, they can only react in limited ways. They may become weakened, stretch and increase in size, or become narrow – even to the point of closing off entirely.
If a blood vessel becomes inflamed and narrowed, blood supply to that area may be partially or completely eliminated. If collateral blood vessels (thought of as alternate routes of blood supply) are not available in sufficient quantity to carry the blood to such sites, the tissue supplied by the affected blood vessels will die. This is called infarction.
Because vasculitis can occur in any part of the body, any tissue or organ can be at risk.
Frequency:Rare in IBD
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