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Pyoderma Gangrenosum in an African American Male Initially Presenting as Sepsis

Carly E Wallace1, Amit Sharma2

  • 1College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.

Cureus
|March 1, 2022
PubMed

Insights

Pyoderma gangrenosum (PG) is a rare skin condition. Early diagnosis and corticosteroid treatment are key for managing this challenging neutrophilic dermatosis.

Area of Science:

  • Dermatology
  • Internal Medicine
  • Pathology

Background:

  • Pyoderma gangrenosum (PG) is an uncommon, ulcerative, neutrophilic dermatosis.
  • Diagnosis and treatment of PG can be complex and challenging.
  • This condition requires prompt recognition and management.

Observation:

  • A 47-year-old African American male presented with a painful shin ulcer, fever, leukocytosis, and tachycardia.
  • The patient had a history of a similar healed lesion seven years prior.
  • Initial suspicion was sepsis, but pathergy, rapid lesion progression, and sterile cultures suggested PG.

Findings:

  • Pyoderma gangrenosum was diagnosed based on clinical presentation and history.
  • The patient's ulcer showed rapid progression and was associated with systemic symptoms.
  • Sterile wound cultures ruled out infectious etiologies.

Implications:

  • Corticosteroid therapy led to significant improvement in the patient's condition.
  • This case highlights the importance of considering PG in ulcerative skin lesions.
  • Prompt diagnosis and appropriate treatment are crucial for favorable outcomes in PG.
Keywords:
neutrophilic dermatosispathergypyoderma gangrenosumsepsissoft tissue infection

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