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Chronic ulcer in a patient with essential thrombocythemia taking hydroxyurea
Nolan Maloney, Roberto Novoa, Jennifer E Yeh1
1Department of Dermatology, Stanford University School of Medicine, California, USA. jeyeh@stanford.edu.
Dermatology Online Journal
|August 1, 2024
Summary
Pyoderma gangrenosum can be misdiagnosed in chronic skin ulcers. Recognizing atrophie blanche on clinical examination is crucial to avoid incorrect treatment with corticosteroids.
Area of Science:
- Dermatology
- Pathology
Background:
- Chronic skin ulcers present a diagnostic challenge.
- Pyoderma gangrenosum is a diagnosis of exclusion often considered for non-healing ulcers.
Observation:
- Clinical examination of chronic skin ulcers may reveal specific features.
- Atrophie blanche, characterized by scarred, white, atrophic plaques, is a key clinical sign.
Findings:
- The presence of atrophie blanche suggests an alternative diagnosis to pyoderma gangrenosum.
- Misdiagnosis can lead to inappropriate treatment with immunosuppressive therapies.
Implications:
- Accurate diagnosis of chronic skin ulcers is essential for effective management.
- Avoiding unnecessary corticosteroid and immunosuppressive treatment prevents potential adverse effects.
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