Giant and severe pyoderma gangrenosum: about a case

Pyoderma gangrenosum is a non infectious neutrophilic dermatosis with unknown origin. In contrast to its name, PG is neither an infectious nor gangrenous condition. Half of the cases have associated systemic diseases.1 Here in, we report a case of a 46-year-old male with no significant history of malignancies, systemic vasculitis, arthritis, inflammatory bowel disease, fungal infection, drugs, or cutaneous injury was referred to our Department for multiple ulcers appears on the trunk and limbs evolving with relapses and remissions. Clinical examination showed diffusely distributed, two, well-defined, deep purulent ulcers on the back and the calf measuring 4 to 40 cm, with severe oozing and erosions. Laboratory tests revealed a white cell count of 10.23×109/l, hemoglobin 120g/l, and C-reactive protein 12 mg/l. All other tests were normal, including hepatic function tests, renal tests, antinuclear antibodies, anti-neutrophil cytoplasmic antibodies, HIV, hepatitis, and Venereal Disease Research Laboratory test for syphilis. A body scan and colonoscopy were performed and was normal. The patient was treated with systemic glucocorticoids (60mg daily) and topical wound care with partial improvement.