How to Save a Limb: Identification of Pyoderma Gangrenosum

We report the case of a 67-year-old woman with a painful expanding ulcer on the left leg of 2 months' duration that initially was diagnosed as a skin and soft tissue infection (SSTI) with plans for surgical debridement. Upon dermatologic consultation, surgery was canceled due to the possible diagnosis of pyoderma gangrenosum (PG) and risk of pathergy. Notable features of this patient included a history of inflammatory bowel disease (IBD), poor response to antibiotics, chronicity, lack of signs of sepsis, potential complications of surgical intervention, and ultimately a response to immunosuppressive agents.