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Pyoderma gangrenosum with wrist joint destruction: case report
Hyonmin Choe1, Hiroaki Sakano, Hidetake Takigami
1Department of Orthopaedic Surgery, Yokohama City University School of Medicine, Yokohama, Japan. hyonmin@hotmail.com
The Journal of Hand Surgery
|December 27, 2012
Summary
Pyoderma gangrenosum (PG) is a rare skin condition that can mimic infections. Early consideration of PG is crucial for patients with unusual, painful skin ulcers to ensure proper diagnosis and treatment.
Area of Science:
- Dermatology
- Rheumatology
- Internal Medicine
Background:
- Pyoderma gangrenosum (PG) is a rare, noninfectious, neurotrophic dermatosis.
- PG commonly presents as a skin ulcer but can have systemic manifestations.
- Ulcerative colitis is a frequent comorbidity associated with PG.
Observation:
- A case of PG mimicking infectious osteoarticular and cutaneous conditions was observed.
- The patient presented with a forearm ulcer, wrist pain, anemia, and inflammation.
- The ulcer extended to the joint, causing osteochondral tissue destruction.
Findings:
- Carpal osteolysis was noted in the affected wrist.
- Advanced ulcerative colitis was identified as the underlying condition.
- Standard antibiotic and surgical interventions were ineffective for the ulcer.
Implications:
- Corticosteroid therapy successfully treated the intractable ulcer.
- PG should be considered in patients with painful, unusual skin lesions, even when mimicking infections.
- Timely diagnosis and appropriate treatment are essential for managing complex PG cases.
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