Pyoderma gangrenosum Preceding the Diagnosis of Systemic Lupus erythematosus

Abstract

Patients with systemic lupus erythematosus (SLE) often develop leg ulceration, particularly those with antiphospholipid antibodies or with vasculitis. Pyoderma gangrenosum (PG) is an idiopathic ulcerative neutrophilic dermatosis that is commonly associated with inflammatory bowel disease or seronegative polyarthritis. Although PG-like lesions have been commonly described in patients with the antiphospholipid antibody syndrome, the occurrence of PG as a preceding manifestation of SLE has only rarely been reported. We present a patient who developed PG roughly 8 years prior to developing SLE.

A Case of Amicrobial Pustulosis of the Folds Associated with Neutrophilic Gastrointestinal Involvement in Systemic Lupus Erythematosus

“…In acute generalized exanthematous pustulosis, which also constitutes an amicrobial spongiform pustulosis, the rash is usually widespread and is frequently triggered by drug ingestion or viral infection [17]. Finally, pyoderma-gangrenosum-like lesions with a cutaneous neutrophilic infiltrate have been observed prior to the development of SLE [18]. …”

Two Pediatric Cases of Nonbullous Histiocytoid Neutrophilic Dermatitis Presenting as a Cutaneous Manifestation of Lupus Erythematosus

“…3 In addition, isolated case reports of pyoderma gangrenosum in association with SLE are described in the literature. 4,5 Sweet syndrome and Sweet-like eruptions with histopathologic findings including a diffuse neutrophilic infiltrate and papillary dermal edema have also been described as uncommon manifestations of LE. [6][7][8][9][10][11][12][13] However, many of the patients with LE who present with these neutrophilrich eruptions do not meet the diagnostic criteria for classic Sweet syndrome.…”

Pyoderma Gangrenosum in a Patient With Systemic Lupus Erythematosus: Case Report

“…However there have also been case reports of PG in antiphospholipid antibody (aPL) negative SLE patients [11].…”