A 36-year-old man presented with a large ulceration with elevated cribriform borders on his right lower leg dated one month ago. The patient's past history showed a four-year history of bowel inflammatory disease in remission since two years, and badly controlled diabetes mellitus with persistently elevated blood glucose despite insulin supplementation since one year. The clinical and histology findings were consistent with pyoderma gangrenosum. Patho genic therapy was introduced to achieve full control of his skin symptoms. Pyoderma gangrenosum is a common skin complication and manifestation of Crohn's disease. It could rarely occur in patients with in sulin-dependent diabetes. Remarkably, the constellation of inflammatory bowel disease, diabetes and pyoderma gangrenosum is an ecdotal and may suggest susceptibility to multiple autoimmune syndrome. Herein, this unique case of complicated autoimmune disturbance is reported to point out the importance of Th1 stimulated regulatory mechanism information of skin, intestinal and glandular disorders.
Scripta Scientifica Medica 2010;42(1):17-19