Kareem Abu-Elmagd, MD; David H. Van Thiel, MD; Brian V. Jegasothy, MD; Jerry C. Jacobs, MD; Patricia Carroll, MD; Horacio Rodriquez-Rilo, MD; Cheryl D. Ackerman, MD; John J. Fung, MD, PhD; Thomas E. Starzl, MD, PhD
Abu-Elmagd K, Van Thiel DH, Jegasothy BV, Jacobs JC, Carroll P, Rodriquez-Rilo H, et al. Resolution of Severe Pyoderma Gangrenosum in a Patient with Streaking Leukocyte Factor Disease after Treatment with Tacrolimus (FK 506). Ann Intern Med. 1993;119:595-598. doi: 10.7326/0003-4819-119-7_Part_1-199310010-00008
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Published: Ann Intern Med. 1993;119(7_Part_1):595-598.
Severe, lifelong, unresolving pyoderma gangrenosum occurs in association with recurrent episodes of sterile pyoarthrosis and the presence of a serum factor (called streaking leukocyte factor)  responsible for enhancing random migration of purified human neutrophils and mononuclear leukocytes in vitro. Pyoderma gangrenosum is only one feature of this unusual disease. Minor trauma of any sort leads to an excessive accumulation of both mononuclear and polymorphonuclear leukocytes in tissue. This causes subcutaneous induration, sterile abscesses, sterile pyoarthrosis, and extensive areas of skin necrosis similar to those occurring in classical pyoderma gangrenosum, except that the lesions are larger and more confluent. The arthritic lesions are characterized by synovial fluid leukocyte counts greater than 100 000/mm3 and a severe synovitis . We describe a patient with the streaking leukocyte factor syndrome who has been treated successfully with tacrolimus (FK 506, Prograf, Fujisawa Pharmaceutical Co., Osaka, Japan).
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Emergency Medicine, Endocrine and Metabolism, Infectious Disease, Nephrology, Rheumatology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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