A clinical case report of Pyoderma gangrenosum

Abstract

Pyoderma gangrenosum is a chronic infl ammatory dermatosis,
of unknown aetiology,^1,2 which presents as painful and rapidly
progressive necrotizing and ulcerative skin lesions. It may be
associated with other pathologies, such as infl ammatory bowel
disease, rheumatoid arthritis, Behçet disease, Wegener’s granulomatosis, active chronic hepatitis, or other blood diseases (multiple
myeloma, other monoclonal gammopathies, leukaemia).^1,2 However, approximately 50% of the cases arise in isolation.¹
The authors describe a clinical case who presented with ulcerated lesions in the lower limbs. Despite the absence of respiratory, cardiac, pulmonary or genito-urinary complaints, the initial
analytical assessment detected leukocytosis, thrombocytosis,
normocytic normochromic anaemia and discrete renal failure. The
patient was admitted to clarify the clinical picture and, if possible,
to exclude underlying systemic disease.
The diagnosis was found to be pyoderma gangrenosum associated with systemic vasculitis, probably Wegener’s granulomatosis.
Early haemodialysis was necessary due to rapid and progressive
renal dysfunction. Nevertheless, therapy with corticosteroids and
immunosuppressants markedly improved skin lesions and renal function was restored.