From Daily to Rarity - A Case Report of Ulcerative Pyoderma Gangrenosum

Abstract

Pyoderma gangrenosum (PG) is classified as a non-infectious neutrophilic dermatosis with poorly understood etiology. Pathergy, which is major trauma caused by a minor incident, has been associated as a preceding event for PG. The epidemiology of the disease reveals patients who present with PG have associated underlying conditions with the most common comorbidities reported as inflammatory bowel disease, rheumatoid arthritis, hematological and solid organ malignancies. Pyoderma gangrenosum is considered a diagnosis of exclusion. It is commonly a missed diagnosis leading to delays in treatment. A diagnostic guide which clinicians can use is the PARACELSUS score. The following case report will focus on a relatively healthy 50-year-old female with a past medical history of hypertension who is in complete remission from breast cancer. This case highlights the importance of keeping PG in the differential diagnosis in patients without a history of autoimmune disease.