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Nodular Scleritis and Pyoderma Gangrenosum Associated with Active Ulcerative Colitis: A Case Report
Kazuki Yashiro1, Sozaburo Ihara2, Hikari Boki3
1Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan.
Case Reports in Ophthalmology
|July 9, 2025
Summary
This case highlights a rare instance of ulcerative colitis (UC) presenting with both nodular scleritis and pyoderma gangrenosum. Prompt recognition and treatment of these systemic symptoms led to significant improvement in ocular and skin inflammation.
Area of Science:
- Ophthalmology
- Dermatology
- Gastroenterology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis.
- Ocular involvement in PG is atypical, with nodular scleritis being an uncommon manifestation.
Observation:
- A 55-year-old male with active UC developed bilateral nodular scleritis and peripheral corneal ulceration.
- Concurrently, the patient presented with multiple painful skin abscesses, diagnosed as PG via biopsy.
- Elevated inflammatory markers and PR3-ANCA were noted, with vasculitis ruled out.
Findings:
- The patient was diagnosed with nodular scleritis and PG secondary to active UC.
- Topical treatments for scleritis were ineffective.
- Initiation of oral glucocorticoids resulted in significant improvement of both ocular and skin inflammation, alongside UC remission.
Implications:
- This case emphasizes the rare association between UC, nodular scleritis, and PG.
- Recognizing systemic symptoms is crucial for diagnosing the underlying cause of scleritis.
- Timely and appropriate treatment, including systemic therapy, can effectively manage these complex conditions.
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