Pyoderma gangrenosum with Takayasu's arteritis: A rare association

Abstract

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterized by destructive, necrotizing, and noninfective ulceration of skin which most commonly involve lower extremities. We are reporting a case of 20-year-old male who presented with multiple nodulo-ulcerative plaques on both thighs which showed histopathological findings of granulomatous reaction. He was initially treated ineffectively with anti-tubercular agents. Following a revised diagnosis of PG, dexamethasone pulse therapy (100 mg daily for 3 consecutive days in a month) was initiated and the lesions improved with three such pulses. However, the patient was lost to follow-up. The patient presented a year later with relapse and pulse therapy was restarted. Incidental finding of absence of peripheral pulse and nonrecordable blood pressure on left upper limb led to the diagnosis of Takayasu's arteritis (TA). Skin lesions improved and the patient was referred for the management of TA. Association of PG with TA is rare and very few cases have been reported from India till date.