Self-Destructive Dermatosis Mimicking Pyoderma Gangrenosum: A Clinical Case
Background. Polymorphism of clinical manifestations of mental pathology in dermatology often leads to diagnostic errors and severe social exclusion of patients.Clinical case description. The presented clinical case demonstrated the similarity of the clinical picture of self-destructive dermatosis wi...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
Ministry of Healthcare of the Russian Federation. “Kuban State Medical University”
2022-12-01
|
| Series: | Кубанский научный медицинский вестник |
| Subjects: | |
| Online Access: | https://ksma.elpub.ru/jour/article/view/2925 |
| _version_ | 1797295360621674496 |
|---|---|
| author | M. M. Tlish M. I. Gluzmin N. L. Sycheva M. E. Shavilova V. V. Lazarev A. G. Shevchenko |
| author_facet | M. M. Tlish M. I. Gluzmin N. L. Sycheva M. E. Shavilova V. V. Lazarev A. G. Shevchenko |
| author_sort | M. M. Tlish |
| collection | DOAJ |
| description | Background. Polymorphism of clinical manifestations of mental pathology in dermatology often leads to diagnostic errors and severe social exclusion of patients.Clinical case description. The presented clinical case demonstrated the similarity of the clinical picture of self-destructive dermatosis with the symptoms of pyoderma gangrenosum, which determined our differential diagnostic search. Ulcerous defects in the patient were localized in places accessible for self-destruction and did not cause severe pain characteristic of pyoderma gangrenosum. In addition, lack of association with systemic diseases, unsuccessful long-term dermatological treatment, uniformity of skin lesions, and rapid healing of skin manifestations resulting in a scar were more characteristic of self-destructive dermatosis. A pathomorphological examination of the skin revealed morphological data typical of artificial dermatitis in combination with sclerotic changes, and excluded the presence of granulomatous diseases, vasculitis, and deep purulent inflammation of the dermis (neutrophilic dermal abscesses). Thus, histological changes in the biopsy material did not correspond to the clinical skin manifestations. The constant self-destructive actions of the patient resulted in excoriations, ulcerations, with the subsequent secondary infection and conspicuous cicatricial skin changes.Conclusion. The presented clinical case demonstrated the complexity of the diagnostic search for a psychodermatological disorder due to the similarity of the clinical picture of self-destructive dermatosis with the symptoms of pyoderma gangrenosum, which led to a delayed diagnosis. |
| first_indexed | 2024-03-07T21:46:36Z |
| format | Article |
| id | doaj.art-a541b3750fcc40c29242a7fb44fb3c0b |
| institution | Directory Open Access Journal |
| issn | 1608-6228 2541-9544 |
| language | Russian |
| last_indexed | 2024-03-07T21:46:36Z |
| publishDate | 2022-12-01 |
| publisher | Ministry of Healthcare of the Russian Federation. “Kuban State Medical University” |
| record_format | Article |
| series | Кубанский научный медицинский вестник |
| spelling | doaj.art-a541b3750fcc40c29242a7fb44fb3c0b2024-02-25T10:57:26ZrusMinistry of Healthcare of the Russian Federation. “Kuban State Medical University”Кубанский научный медицинский вестник1608-62282541-95442022-12-01296849510.25207/1608-6228-2022-29-6-84-951342Self-Destructive Dermatosis Mimicking Pyoderma Gangrenosum: A Clinical CaseM. M. Tlish0M. I. Gluzmin1N. L. Sycheva2M. E. Shavilova3V. V. Lazarev4A. G. Shevchenko5Kuban State Medical UniversityKuban State Medical UniversityKuban State Medical UniversityKuban State Medical UniversityKuban State Medical UniversityClinical Dermatovenerologic Dispensary, Krasnodar KraiBackground. Polymorphism of clinical manifestations of mental pathology in dermatology often leads to diagnostic errors and severe social exclusion of patients.Clinical case description. The presented clinical case demonstrated the similarity of the clinical picture of self-destructive dermatosis with the symptoms of pyoderma gangrenosum, which determined our differential diagnostic search. Ulcerous defects in the patient were localized in places accessible for self-destruction and did not cause severe pain characteristic of pyoderma gangrenosum. In addition, lack of association with systemic diseases, unsuccessful long-term dermatological treatment, uniformity of skin lesions, and rapid healing of skin manifestations resulting in a scar were more characteristic of self-destructive dermatosis. A pathomorphological examination of the skin revealed morphological data typical of artificial dermatitis in combination with sclerotic changes, and excluded the presence of granulomatous diseases, vasculitis, and deep purulent inflammation of the dermis (neutrophilic dermal abscesses). Thus, histological changes in the biopsy material did not correspond to the clinical skin manifestations. The constant self-destructive actions of the patient resulted in excoriations, ulcerations, with the subsequent secondary infection and conspicuous cicatricial skin changes.Conclusion. The presented clinical case demonstrated the complexity of the diagnostic search for a psychodermatological disorder due to the similarity of the clinical picture of self-destructive dermatosis with the symptoms of pyoderma gangrenosum, which led to a delayed diagnosis.https://ksma.elpub.ru/jour/article/view/2925self-destructive dermatosispyoderma gangrenosumdiagnostic errorshistopathological examination |
| spellingShingle | M. M. Tlish M. I. Gluzmin N. L. Sycheva M. E. Shavilova V. V. Lazarev A. G. Shevchenko Self-Destructive Dermatosis Mimicking Pyoderma Gangrenosum: A Clinical Case Кубанский научный медицинский вестник self-destructive dermatosis pyoderma gangrenosum diagnostic errors histopathological examination |
| title | Self-Destructive Dermatosis Mimicking Pyoderma Gangrenosum: A Clinical Case |
| title_full | Self-Destructive Dermatosis Mimicking Pyoderma Gangrenosum: A Clinical Case |
| title_fullStr | Self-Destructive Dermatosis Mimicking Pyoderma Gangrenosum: A Clinical Case |
| title_full_unstemmed | Self-Destructive Dermatosis Mimicking Pyoderma Gangrenosum: A Clinical Case |
| title_short | Self-Destructive Dermatosis Mimicking Pyoderma Gangrenosum: A Clinical Case |
| title_sort | self destructive dermatosis mimicking pyoderma gangrenosum a clinical case |
| topic | self-destructive dermatosis pyoderma gangrenosum diagnostic errors histopathological examination |
| url | https://ksma.elpub.ru/jour/article/view/2925 |
| work_keys_str_mv | AT mmtlish selfdestructivedermatosismimickingpyodermagangrenosumaclinicalcase AT migluzmin selfdestructivedermatosismimickingpyodermagangrenosumaclinicalcase AT nlsycheva selfdestructivedermatosismimickingpyodermagangrenosumaclinicalcase AT meshavilova selfdestructivedermatosismimickingpyodermagangrenosumaclinicalcase AT vvlazarev selfdestructivedermatosismimickingpyodermagangrenosumaclinicalcase AT agshevchenko selfdestructivedermatosismimickingpyodermagangrenosumaclinicalcase |