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Vol. 33. Issue 1.
Pages 46-50 (January - February 2022)
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Vol. 33. Issue 1.
Pages 46-50 (January - February 2022)
Case Report
Cranial aseptic osteomyelitis associated with pyoderma gangrenosum
Osteomielitis aséptica craneal asociada a pioderma gangrenosum
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Enric Piqué-Durana,
Corresponding author
enric@aedv.es

Corresponding author.
, Jesús Morera Molinab, Miguel Ángel Limeres-Gonzálezc, Ana María Espejo-Gild
a Sección de Dermatología, Hospital Dr. José Molina Orosa, Lanzarote, Provincia de Las Palmas, Spain
b Servicio de Neurocirugía, Hospital Universitario de Gran Canaria Doctor Negrín, Provincia de Las Palmas, Spain
c Servicio de Patología, Hospital Universitario de Gran Canaria Doctor Negrín, Provincia de Las Palmas, Spain
d Servicio de Medicina Interna, Hospital Dr. José Molina Orosa, Lanzarote, Provincia de Las Palmas, Spain
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Table 1. Clinical cases: association of ND with aseptic osteomyelitis.
Abstract

Neutrophilic dermatoses include a heterogeneous group of entities. Uncommonly, they can accumulate aseptic neutrophilic abscesses in other tissues in addition to the skin.

A 34-year-old female complained of a headache which was unresponsive to usual drugs. A TAC revealed an osteolytic lesion in the right parietal bone. The biopsy showed osteomyelitis. One year later, pyoderma gangrenosum appeared in the anterior aspect of both legs. The headache and the cutaneous lesions disappeared after treatment with oral prednisone.

The bone involvement in the background of neutrophilic dermatoses is exceptional. Usually, it involves children in the context of chronic recurrent multiple osteomyelitis (CRMO). Only two cases have been described in adults. One of them was a 26-year-old woman who had had CRMO since childhood, and the other one in contiguity with the cutaneous lesions of pyoderma gangrenosum.

Keywords:
Aseptic osteomyelitis
Pyoderma gangrenosum
Neutrophilic dermatoses
Neutrophilic disease
Cranial lytic lesion
Resumen

Las dermatosis neutrofílicas (DN) constituyen un grupo heterogéneo de enfermedades. Excepcionalmente, las DN pueden acompañarse de acúmulos de neutrófilos estériles en otros tejidos distintos a la piel.

Una paciente de 34 años consultó por una cefalea que no respondía al tratamiento analgésico. Un TAC demostró una lesión osteolítica a nivel parietal derecho cuyo estudio histopatológico sugería una osteomielitis. Un año después del inicio de la cefalea desarrolló un pioderma gangrenosum en cara anterior de ambas piernas. Tras tratamiento con corticoterapia sistémica se resolvieron las lesiones cutáneas y la cefalea.

La afectación ósea en las dermatosis neutrofílicas es excepcional. Habitualmente afecta a la población infantil en el contexto de una osteomielitis crónica recurrente multifocal (OCRM). Sólo se han descrito 2 casos en adultos, una paciente de 26 años, con una OCRM desde la infancia, y un varón de 67 años que desarrolló una osteomielitis aséptica en continuidad un pioderma gangrenoso.

Palabras clave:
Osteomielitis aséptica
Pioderma gangrenosum
Dermatosis neutrofílica
Enfermedad neutrofílica
Lesión lítica craneal

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