Maurizio Vecchi 1, Piero Vernia, Gabriele Riegler, Renata D’Incà, Vito Annese, Siro Bagnoli, Clin Exp Gastroenterol. 2013;6:1-7.
Tag: Inflammatory bowel disease
Scientific corner
Therapeutic landscape for ulcerative colitis: where is the Adacolumn(®) system and where should it be?
Granulocyte-monocyte apheresis is a relatively new therapy that has been proposed, sometimes with controversial results, for the treatment of inflammatory bowel disease, particularly ulcerative colitis. The aim of the present study was to perform a thorough review of the literature on the application of this type of treatment in ulcerative colitis and discuss the results, in order to provide an opinion on its use which is shared by the involved experts. The review of the literature was performed by searching PubMed with appropriate key words. The results obtained suggest that the major role for this treatment at this moment is for those patients with steroid dependency or with major contraindications to use of steroids. However, promising, albeit very preliminary, results have also been observed in steroid-naïve subjects, and this is of particular interest in consideration of the safety profile of this therapeutic method. As such, the Adacolumn may prove useful in specific subgroups of patients. Future phenotypic, genotypic, and molecular characterization of patients with inflammatory bowel disease might prove useful in defining better those subjects who might benefit most from this treatment modality.
Scientific corner
Questionnaire Based Assessment of Patients’ Acceptability of Leukocytapheresis for the Treatment of Inflammatory Bowel Disease.
Kazuko Nagase 1, Ken Fukuanga, Yoko Yokoyama, Koji Kamikozuru, Hiroto Miwa, Shiro Nakamura, Ther Apher Dial. 2013 Oct;17(5):490-7.
The aim of the present study was to assess patients’ acceptance of therapeutic leukocytapheresis known as cytapheresis (CAP) for the treatment of an active flare of inflammatory bowel disease (IBD).
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Management of cutaneous disorders related to inflammatory bowel disease
Zaira Pellicer,a Jesus Manuel Santiago,b Alejandro Rodriguez,b Vicent Alonso,a Rosario Antón,b and Marta Maia Boscab ,Ann Gastroenterol. 2012; 25(1): 21–26.
Almost one-third of patients with inflammatory bowel disease (IBD) develop skin lesions. Cutaneous disorders associated with IBD may be divided into 5 groups based on the nature of the association: specific manifestations (orofacial and metastatic IBD), reactive disorders (erythema nodosum, pyoderma gangrenosum, pyodermatitis-pyostomatitis vegetans, Sweet’s syndrome and cutaneous polyarteritis nodosa), miscellaneous (epidermolysis bullosa acquisita, bullous pemphigoid, linear IgA bullous disease, squamous cell carcinoma-Bowen’s disease, hidradenitis suppurativa, secondary amyloidosis and psoriasis), manifestations secondary to malnutrition and malabsorption (zinc, vitamins and iron deficiency), and manifestations secondary to drug therapy (salicylates, immunosupressors, biological agents, antibiotics and steroids). Treatment should be individualized and directed to treating the underlying IBD as well as the specific dermatologic condition. The aim of this review includes the description of clinical manifestations, course, work-up and, most importantly, management of these disorders, providing an assessment of the literature on the topic.
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Pyoderma gangrenosum – a review
Uwe Wollina, Orphanet Journal of Rare Diseases volume 2, Article number: 19 (2007)
Pyoderma gangrenosum (PG) is a rare noninfectious neutrophilic dermatosis. Clinically it starts with sterile pustules that rapidly progress and turn into painful ulcers of variable depth and size with undermined violaceous borders. The legs are most commonly affected but other parts of the skin and mucous membranes may also be involved. Course can be mild or malignant, chronic or relapsing with remarkable morbidity. In many cases PG is associated with an underlying disease, most commonly inflammatory bowel disease, rheumatic or haematological disease and malignancy. Diagnosis of PG is based on history of an underlying disease, typical clinical presentation, histopathology, and exclusion of other diseases that would lead to a similar appearance. The peak of incidence occurs between the ages of 20 to 50 years with women being more often affected than men. Aetiology has not been clearly determined yet.
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