Pyoderma Gangrenosum in Systemic Lupus Erythematosus: An Uncommon Association

Abstract

Pyoderma gangrenosum (PG) is a type of neutrophilic diseases and is an uncommon, idiopathic, ulcerative dermatosis. On the contrary, systemic lupus erythematosus (SLE) is a chronic, autoimmune, multisystem, progressive disease that causes widespread inflammation in joints, skin, blood vessels, and several other organs. The rash of SLE is usually on photo-distributed areas, especially the face. PG-like ulceration was previously reported with antiphospholipid antibody syndrome; however, the association of PG and SLE is rarely observed. We report a rare manifestation of SLE presenting as ulcerative PG in a 46-year-old female who was diagnosed with SLE with no evidence of inflammatory bowel disease, rheumatoid arthritis, chronic active hepatitis, monoclonal gammopathies, and hematological malignancies. She developed a skin lesion on her right breast region which was later diagnosed to be PG following biopsy and was managed with corticosteroids and appropriate wound management.