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Bilateral Idiopathic Pyoderma Gangrenosum: A Case Report of an Atypical Presentation
Sanjog Thapa Magar1, Deekshanta Sitaula1, Subi Rijal1
1Department of Dermatology and Venereology Patan Academy of Health Sciences Lalitpur Nepal.
Clinical Case Reports
|January 30, 2026
Summary
Pyoderma gangrenosum (PG) is a rare skin condition causing painful ulcers. This case highlights bilateral PG, emphasizing early biopsy and corticosteroid treatment for accurate diagnosis and healing.
Area of Science:
- Dermatology
- Pathology
Background:
- Pyoderma gangrenosum (PG) is a rare, non-infectious neutrophilic dermatosis.
- Characterized by rapidly progressive, painful ulcers.
- Bilateral PG is exceptionally rare and often misdiagnosed.
Purpose of the Study:
- To report a rare case of bilateral pyoderma gangrenosum.
- To highlight diagnostic challenges and successful treatment outcomes.
Main Methods:
- A case report of a 76-year-old woman with bilateral leg ulcers.
- Clinical presentation, laboratory tests, and skin biopsy were performed.
- Treatment involved oral prednisolone and saline dressings.
Main Results:
- Patient presented with painful, crusted ulcers unresponsive to antibiotics.
- Skin biopsy confirmed neutrophilic dermatosis consistent with PG.
- Treatment with oral prednisolone led to significant improvement and complete healing.
Conclusions:
- Bilateral PG can mimic infectious or vascular ulcers.
- Early biopsy and prompt corticosteroid therapy are crucial for accurate diagnosis and favorable outcomes.
- PG can occur independently of systemic diseases.
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