Post-surgical Pyoderma Gangrenosum Reveals Celiac Disease in a Pediatric Patient

Pyoderma gangrenosum (PG) is a rare, autoinflammatory neutrophilic dermatosis that may be triggered by cutaneous trauma and is frequently associated with systemic diseases, most commonly inflammatory bowel disease. Celiac disease (CD), an immune-mediated enteropathy precipitated by gluten, is not typically linked with PG, particularly in the pediatric population. We present a highly unusual case of a 13-year-old female who developed post-surgical PG following excision of an epidermoid cyst, ultimately leading to a new diagnosis of CD. Histopathology and clinical features were consistent with PG, with no evidence of infection. The patient was successfully managed with topical corticosteroids and wound care. Subsequent gastrointestinal evaluation revealed positive celiac serologies and confirmatory duodenal biopsy findings. This case highlights the importance of recognizing PG as a potential cutaneous manifestation of undiagnosed CD in pediatric patients and the need for a multidisciplinary approach to prompt diagnosis and treatment.