Painful ulcers and foul-smelling yellow-green pus

Introduction Painful ulcers and yellowish green pus that exudes malodor are a symptom of gangrenous pyoderma. Patients with this disease have a delayed response to DNCB, candida and streptokinase. This can explain that when the reticuloendothelial system is extremely low, new lesions can occur when there is slight damage or injury. This hypersensitivity can also be caused by acupuncture, especially in the acute phase of the disease and near the lesion. strong. Evidence of a well-recognized immune mechanism defect is that many patients have gamma globulin disease, atypical protein disease, T cell dysregulation, or phagocytic defects.

Cause

Etiology: It has been confirmed that patients with this disease have defects in delayed response to DNCB, candida and streptokinase. This can explain that when the reticuloendothelial system is extremely low, new lesions can occur when there is slight damage or injury. This hypersensitivity can also be caused by acupuncture, especially in the acute phase of the disease and near the lesion. strong. It has been confirmed that there is a serum cutaneous necrosis factor which causes skin necrosis in guinea pig skin, but its specificity is unknown. Evidence of a well-recognized immune mechanism defect is that many patients have gamma globulin disease, atypical protein disease, T cell dysregulation, or phagocytic defects.

an examination

Related inspection

Viral infection immunoassay blood test

Diagnosis: Primary skin lesions can be expressed as follows:

1. The tender erythema of the nodule, initially red, and then the center becomes blue, eventually forming a healthy search for ulcers.

2. One or more blisters, pustules, similar to acne, folliculitis, transient acantholytic dermatosis or herpes-like dermatitis. Both lesions can occur at the same time, and can also be converted to each other. Skin lesions can occur in normal skin or areas of the original skin disease. The primary skin lesions gradually edema, and rapidly form ulcers, the boundary is clear, the edges are light blue, often thick and thick, sometimes high and low unevenness and sneak damage. The base of the central ulcer is red, different in depth, like a crater, with a stench on the surface. The yellow-green pus ulcers around the early around have a flush. The skin lesions of the skin and subcutaneous tissue capillary-venous thrombosis continue to expand circumscribing around. Ulcers vary in size, as small as sows can be as large as 10 cm or more in diameter. A large number, up to more than 100 skin lesions and more pain, there are long-term painless parts of the case can be self-healing, leaving atrophic sieving scars. Often without lymph node or lymphatic lesions. Deep dermis or blister bullous type is also not uncommon. This type of skin lesion is mostly single, and other symptoms are associated with health search. Hemorrhagic bullous type is usually a bullous health search. It is superficial, painful, and blister is reachable. This type of 0.5L or higher is often associated with acute leukemia and other myelodysplastic diseases, but 15% of cases have no such related diseases.

Individual cases have manifestations of Behcet syndrome such as oral-genital ulcers or superficial thrombophlebitis. Atypical cases are similar to fulminant purpura, neutrophilic dermatosis, nodular erythema, or nodular vasculitis. Skin lesions can accumulate throughout the body, mainly accumulating calf thighs, buttocks and face. Pustules and aggressive blisters can occur in the lips and oral mucosa, and even in the eyelids and conjunctiva.

20% of cases have a homomorphic response. The rapid decline of systemic symptoms such as toxic symptoms and long-term fever during the active period of the disease depends on the application of corticosteroids, and the body temperature can be reduced to normal within 24 hours. Ulcerative pyoderma ulcers often recur, and can last for several years, but the general condition is still good. Half of the cases are associated with ulcerative colitis, colitis or with or after lesions. In addition, the disease is also associated with many diseases with arthritis, such as Behcet syndrome. The most important and interesting thing is that the disease is associated with diseases of the immune system, including congenital and acquired hypogammaglobulinemia, which is more common, including IgAIgG or IgM disease. It has been reported to be associated with myeloma. Hemorrhagic bullous gangrenous pyoderma is associated with myeloid proliferative diseases such as leukemia, polycythemia, and myeloid fibrosis. The disease overlaps with neutrophil-related diseases such as pustular dermatosis under the cornea.

Complications: Half of the cases are associated with ulcerative colitis, colitis or with or after lesions. In addition, the disease is also associated with many diseases with arthritis, such as Behcet syndrome. Most important and interesting is that the disease is associated with diseases of the immune system, including congenital and acquired hypogammaglobulinemia, which is more commonly associated with IgA IgG or IgM disease. Diagnosis relies on clinical morphology. Painful ulcers on the stalk edge and oozing yellowish green pus with malodor have diagnostic value.

Differential diagnosis

The diagnosis should be differentiated from the following symptoms:

1. Ulcer pain The pain of gastric ulcer is a pain of visceral nature. The location of the body surface is not accurate. At the same time, the pain is not severe, and it can be tolerated. It is characterized by burning pain, pain and discomfort. The active period is rhythmic, manifested as postprandial pain, with periodic and seasonal characteristics as the pathology develops. Ulcers near the cardia can also manifest as a burning sensation in the back of the chest and pain in the left chest. When the ulcer penetrates, it manifests as aggravation of pain, radiation to the back or back pain, and nighttime pain. When the nature of the pain changes and the rhythm changes, you should be alert to the possibility of malignant transformation.

2. The pus is chocolate or the amoeba is found. The pleural amebic disease is based on the clinical manifestations and laboratory tests. It is generally not difficult to diagnose, and the pathogen can be diagnosed by sputum or pleural effusion. Lung and pleural amebiasis are pulmonary and pleural suppurative inflammation caused by the infection of amoeba. The hepatic lesions occur mostly in the right lower lung, and the blood-borne lesions are mostly multiple lesions in both lungs.

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