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Perianal ulcer: An unusual presentation of Wegener's granulomatosis

Report of a case

  • Case Reports
  • Published:
Diseases of the Colon & Rectum

Abstract

A 46-year-old man, without remarkable past medical history, had a perianal ulcer that appeared spontaneously two months before presentation. At admission, the ulcer was painless, measuring 4 to 5 cm in diameter and showing detachment and a slightly papillomatous aspect at the edge but without induration of the base. Microscopic examination revealed cutaneous ulceration with a well-developed inflammatory response, a few small vessels with intraluminal thrombosis or necrotizing walls, and isolated microscopic granulomata. No infectious disease was detected. The diagnosis of Wegener's granulomatosis was made six months later, when the disease was clinically evident in three principal sites: upper airways, lung, and kidney. At that time, serum antineutrophil cytoplasmic autoantibodies were detected with indirect immunofluorescence microscopy. There has been an excellent response to immunosuppressive therapy. Review of the literature revealed no similar reports.

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Authors and Affiliations

  1. Departement of Pathology, University Hospital, Nancy, France

    Bernadette Aymard M.D., Marc A. Bigard M.D., Henry Thompson M.D., Jean L. Schmutz M.D., Jean F. Finet M.D. & Jacques Borrelly M.D.

  2. Department of Gastroenterology, University Hospital, Nancy, France

    Bernadette Aymard M.D., Marc A. Bigard M.D., Henry Thompson M.D., Jean L. Schmutz M.D., Jean F. Finet M.D. & Jacques Borrelly M.D.

  3. Department of Dermatology, University Hospital, Nancy, France

    Bernadette Aymard M.D., Marc A. Bigard M.D., Henry Thompson M.D., Jean L. Schmutz M.D., Jean F. Finet M.D. & Jacques Borrelly M.D.

  4. Department of Thoracic Surgery, University Hospital, Nancy, France

    Bernadette Aymard M.D., Marc A. Bigard M.D., Henry Thompson M.D., Jean L. Schmutz M.D., Jean F. Finet M.D. & Jacques Borrelly M.D.

  5. General Hospital and University of Birmingham, Birmingham, UK

    Bernadette Aymard M.D., Marc A. Bigard M.D., Henry Thompson M.D., Jean L. Schmutz M.D., Jean F. Finet M.D. & Jacques Borrelly M.D.

Authors
  1. Bernadette Aymard M.D.
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  2. Marc A. Bigard M.D.
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  3. Henry Thompson M.D.
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  4. Jean L. Schmutz M.D.
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  5. Jean F. Finet M.D.
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  6. Jacques Borrelly M.D.
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Additional information

This case was discussed as a Diagnostic Problem at the 5eme Club Franco-Britannique de Pathologie Digestive Meeting in Rouen, October 15, 1988.

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Aymard, B., Bigard, M.A., Thompson, H. et al. Perianal ulcer: An unusual presentation of Wegener's granulomatosis. Dis Colon Rectum 33, 427–430 (1990). https://doi.org/10.1007/BF02156272

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