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 Table of Contents  
TEACHING IMAGES
Year : 2013  |  Volume : 1  |  Issue : 2  |  Page : 197-198

Pyoderma gangrenosum


1 Department of Dermatology, General Medicine, Yenepoya Medical College, Yenepoya University, Deralakatte, Mangalore, Karnataka, India
2 Department of Dermatology, K S Hegde Medical Academy, Nitte University, Deralakatte, Mangalore, Karnataka, India

Date of Web Publication13-Dec-2013

Correspondence Address:
Manjunath M Shenoy
Department of Dermatology, Yenepoya Medical College, Nithyananda Nagara, Deralakatte, Mangalore - 575 018, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2321-4848.123054

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How to cite this article:
Bendigeri MA, Shenoy MM, Girisha BS. Pyoderma gangrenosum. Arch Med Health Sci 2013;1:197-8

How to cite this URL:
Bendigeri MA, Shenoy MM, Girisha BS. Pyoderma gangrenosum. Arch Med Health Sci [serial online] 2013 [cited 2019 Dec 9];1:197-8. Available from: http://www.amhsjournal.org/text.asp?2013/1/2/197/123054


  Case Report Top


A 35-year-old lady presented with recurrent ulcerations over the lower extremities since 6 months. They were painful and rapidly progressive ulcers, and were characterized by the presence of violaceous undermined borders and necrotic centers [Figure 1]. They heal slowly with treatment leading to cribriform scarring [Figure 2]. Skin biopsy from the edge of the ulcer revealed ulcerated epidermis with central necrosis along with massive infiltration of neutrophils in the dermis; there was no leukocytoclasia or vasculitis. Diagnosis of pyoderma gangrenosum (PG) was made based on the clinical findings supported by the histology depicting a neutrophilic dermatosis.
Figure 1: Rapidly progressive ulcer with necrotic base and violaceous margins

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Figure 2: Healing of ulcers with cribriform scarring

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  Discussion Top


PG is a rare neutrophilic dermatosis of unknown etiology characterized by severe tissue destruction and ulceration. It is more frequent in females and can occur at any age. It can occur on any cutaneous surface, but most commonly on the lower legs with preference for the pre-tibial area. [1] Many patients have associated systemic diseases like rhematological diseases, inflammatory bowel disease, and malignancies, especially hematological. [2] Thus, PG can be considered as a cutaneous marker of an underlying serious internal disorder. Ulceration is the most common presentation of PG, but it may present as bullous, pustular, or vegetative lesion. [2] Therapy is difficult and requires systemic immunosuppression using agents like steroids, cyclosporine, mycophenolate, tacrolimus, and infliximab.

 
  References Top

1.Wollina U. Pyoderma gangrenosum - a review. Orphanet J Rare Dis 2007;2:19.  Back to cited text no. 1
[PUBMED]    
2.Brooklyn T, Dunnill G, Probert C. Diagnosis and treatment of pyodermagangrenosum. BMJ 2006;333:181-4.  Back to cited text no. 2
[PUBMED]    


    Figures

  [Figure 1], [Figure 2]



 

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