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Pyoderma gangrenosum or necrotising fasciitis? Diagnostic and therapeutic wanderings

M Vaysse-Vic1, P-A Mathieu1, A Charissoux2

  • 1Service d'orthopédie-traumatologie, hôpital universitaire de Limoges, 2, avenue Martin-Luther-King, 87000 Limoges, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|March 14, 2017
PubMed

Insights

This case report details a 77-year-old female with post-traumatic lower-limb pyoderma gangrenosum (PG). Misdiagnosed initially, effective treatment confirmed PG after ruling out other severe conditions.

Area of Science:

  • Dermatology
  • Clinical Case Study

Background:

  • Pyoderma gangrenosum (PG) is a rare, inflammatory ulcerative skin condition.
  • Diagnosis of PG is often challenging due to its varied presentation and exclusion criteria.

Observation:

  • A 77-year-old female presented with a lower-limb ulceration post-trauma.
  • Initial misdiagnosis included necrotising fasciitis and bacterial dermo-hypodermitis.
  • Standard treatments for these conditions were ineffective.

Findings:

  • Clinical presentation and investigation results pointed towards PG.
  • Therapeutic trial with appropriate treatment led to a positive response.
  • Exclusion of other dermatological and infectious conditions confirmed the diagnosis.

Implications:

  • Highlights the importance of considering PG in atypical ulcerative lesions, especially post-trauma.
  • Emphasizes the diagnostic challenge and need for re-evaluation when treatments fail.
  • Underscores the value of therapeutic trials in diagnosing challenging cases of pyoderma gangrenosum.
Keywords:
DiagnosisLegPyoderma gangrenosumSkin diseases

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