Pyoderma Gangrenosum: The Great Pretender and a Challenging Diagnosis

Abstract

When approached with a rapidly growing ulcerated lesion that does not respond to operative therapy, the possibility of PG should be entertained and a high-dose corticosteroid regimen and/or immunomodulator therapy implemented.

Old but Gold: The Importance of Medical History in Diagnosing Neutrophilic Dermatoses Characterized by Pathergy. A Case of Pyoderma Gangrenosum

“…PG is a diagnosis of exclusion and recognizing PG can be very challenging [6,7]. There are no definitive tests, and excluding other causes almost always requires a skin biopsy and tissue culture.…”

Rare Presentation of Postsurgical Pyoderma Gangrenosum Presenting as Necrotizing Soft Tissue Infection

“…Common sites of involvement are the breasts and abdomen. 6 Frequently mistaken for a wound infection, antibiotics do not alleviate the condition. Any incision and debridement performed in response usually cause further spread of the lesions because of pathergy resulting from the additional trauma.…”

Giant ulcerative lesion on the upper back: using a differential diagnosis to formulate a clinical approach

“…The diagnosis of pyoderma gangrenosum occurring independently is unlikely. 3 For an infectious process, the differential diagnosis would include Buruli ulcer, which is focally endemic in Sub-Saharan Africa and is caused by Mycobacterium ulcerans ; phagedenic ulcer, a polybacterial infection with higher incidence in tropical regions; and necrotizing fasciitis caused by Gram- positive cocci. 4 , 5 Of these infections, necrotizing fasciitis is associated with high fever and rapid progression.…”

“…A tomografia computadorizada mostrou erosão dos processos espinhosos torácicos, porém não havia evidência de doença metastática. O hemograma relevou hemoglobina e leucócitos de 4,6g/dL e 6,9 células x 10 3 /µL, respectivamente. Na internação, o paciente recebeu transfusão devido à sua anemia assintomática e iniciou terapia com sulfato ferroso.…”

“…O diagnóstico de piodermite gangrenosa de modo independente é improvável. 3 Para um processo infecioso, o diagnóstico diferencial deve incluir úlcera de Buruli, que é focalmente endêmica na África Subsaariana e causada por Mycobacterium ulcerans ; úlcera fagedênica, infecção polibacteriana com alta incidência em regiões tropicais; e fasciite necrosante, causada por cocos Gram -positivos. 4 , 5 Dessas infecções, a fasciite necrosante é associada com febre alta e progressão rápida.…”