Pyoderma gangrenosum

What you need to knowPyoderma gangrenosum presents as a rapidly evolving ulcerative lesionA key diagnostic clue is severe pain that may seem out of proportion to the clinical appearancePyoderma gangrenosum is often associated with underlying systemic diseaseMissing a diagnosis of pyoderma gangrenosum can result in inappropriate debridement of the skin and subcutaneous tissue, leading to serious harmA 51 year old woman presented to her general practitioner with a very painful ulcer on her right leg. She had no notable medical history and did not take any medications. She did not recall sustaining any recent injury to her leg but reported having noticed several small pustules in the same area the previous week. On examination, her temperature was 37.9°C, and there was a single purulent 2×2 cm ulceration on her leg with dusky purple borders and surrounding erythema. She was prescribed topical antibiotics. She returned two weeks later with worsening pain….
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