Atypical ulcers localized in the head-neck region: a case report

Abstract

The authors report the case of a 31-year-old male patient who presented with rapidly evolving, painful cutaneous ulcers localized in the head and neck regions, destroying the surrounding tissues. He had a 10 year history of inflammatory bowel disease, which remained untreated due to poor compliance. Owing to the atypical localization and bizarre manifestation of the ulcers, the possibility of cutaneous tuberculosis and Crohn’s disease/ / other inflammatory bowel disease associated pyoderma gangrenosum was raised. Based on the clinical characteristics, the histological examination and the use of PARACELSUS scoring system, the diagnosis of pyoderma gangrenosum was confirmed. The implementation of systemic immunosuppressive therapy resulted in the complete healing of the ulcers and total remission of inflammatory bowel disease. The authors underline the possibility of pyoderma gangrenosum in the case of atypical ulcers appearing in the head and neck region, in the diagnosis of which PARACELSUS scoring system can help.