<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022017000100028</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Pioderma gangrenoso ulceroso asociado a artritis reumatoide: reporte de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Ulcerative pyoderma gangrenosum associated with rheumatoid arthritis: a case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acón-Ramírez]]></surname>
<given-names><![CDATA[Elizabeth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Argüello-Ruiz]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Rafael Ángel Calderón Guardia Hospital Rafael Ángel Calderón Guardia Servicio de Dermatología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2017</year>
</pub-date>
<volume>59</volume>
<numero>1</numero>
<fpage>28</fpage>
<lpage>31</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022017000100028&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022017000100028&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022017000100028&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El pioderma gangrenoso corresponde a una dermatosis crónica inflamatoria rara, cuya etiología y patogénesis es aún incierta, aunque factores inmunológicos y disfunción neutrofílica parecen desempeñar un papel importante. Se presenta en la mayoría de los casos asociada a enfermedad sistémica no infecciosa, como artritis reumatoide, malignidad hematológica y enfermedad inflamatoria intestinal (EII). Es más común en mujeres entre la tercera y quinta década de la vida y puede presentarse como cuatro variantes clínicas distintas que conllevan a ulceración de la piel, con topografía predominante a nivel de extremidades inferiores. Su diagnóstico es meramente clínico y de exclusión y el tratamiento a menudo amerita medidas locales y sistémicas. Se describe aquí el caso clínico de una paciente femenina de 38 años con pioderma gangrenoso variante ulcerativa, asociado a artritis reumatoide, quien presentó excelente evolución clínica posterior a instaurado el tratamiento esteroideo sistémico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Pyoderma gangrenosum is a rare chronic inflammatory dermatosis of unknown etiology and pathogenesis, although immunological factors and neutrophil dysfunction are believed to play an important role. In most cases it is associated with non-infectious systemic diseases such as rheumatoid arthritis, hematologic malignancies and inflammatory bowel disease. It is more common in women with a peak incidence between the third and fifth decades of life and it may present in four distinct clinical forms, all leading to ulceration of the skin, with involvement predominantly of the lower limbs. The diagnosis is based on the clinical manifestations and exclusion of other entities. Frequently systemic and local therapy is required. The clinical case of a 38 year old woman with ulcerative pyoderma gangrenosum associated with rheumatoid arthritis who had an excellent response to treatment with systemic steroids is described.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[pioderma gangrenoso]]></kwd>
<kwd lng="es"><![CDATA[phagédénisme géométrique]]></kwd>
<kwd lng="es"><![CDATA[enfermedad inflamatoria intestinal]]></kwd>
<kwd lng="es"><![CDATA[artritis reumatoide]]></kwd>
<kwd lng="en"><![CDATA[Pyoderma gangrenosum]]></kwd>
<kwd lng="en"><![CDATA[phagédénisme géométrique]]></kwd>
<kwd lng="en"><![CDATA[Inflammatory bowel disease]]></kwd>
<kwd lng="en"><![CDATA[rheumatoid arthritis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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