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Peritoneal Dialysis Exit Site Pyoderma Gangrenosum: A Case Report
Salman Anwar1, Karen Holfeld2, Bhanu Prasad3
1College of Medicine, University of Saskatchewan, Regina Campus, Regina, Saskatchewan, Canada.
Case Reports in Nephrology and Dialysis
|December 22, 2018
Summary
Pyoderma gangrenosum (PG) is a rare inflammatory condition. This case highlights PG occurring at a peritoneal dialysis catheter exit site, emphasizing its consideration in non-healing ulcers unresponsive to antibiotics.
Area of Science:
- Dermatology
- Nephrology
Background:
- Pyoderma gangrenosum (PG) is a rare, chronic inflammatory disorder often misdiagnosed due to lack of specific markers.
- It is frequently associated with inflammatory bowel disease, rheumatological diseases, and hematological malignancies.
Observation:
- A 53-year-old male with end-stage renal disease developed a painful, rapidly progressing ulcer at his peritoneal dialysis (PD) catheter site.
- The ulcer presented with purulent exudates and a violaceous border, unresponsive to initial treatments.
Findings:
- Biopsy ruled out infection, malignancy, and vasculitis, leading to a clinical diagnosis of PG.
- The patient achieved complete resolution of the ulcer after treatment with cyclosporine, following initial worsening with oral prednisone.
Implications:
- This is the first reported case of PG at a PD catheter exit site.
- Clinicians should consider PG in the differential diagnosis for painful, non-healing ulcers at PD catheter sites, especially when unresponsive to antibiotics.
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