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 © 2001-2009, DermAtlas | Image Name: | pyoderma_ganrenosum_1_090617 | File Type: | jpg | |
| Diagnosis: | PYODERMA GANGRENOSUM | Category: | ulcer / reactive erythema | ||
| Body Site: | ankle / foot / foot | Age: | 12 years | ||
| Contributor: | Yung Kelly | ||||
| Description: | healing ulcers and scars with surrounding erythema and hyperpigmentation | ||||
| Comments: | This 12-year-old boy had recurrent and persistent painful ulcers on his leg and ankle. He did improve on oral prednisone, buit when the medication was tapered new lesions appeared on the ankle. He had no history of inflammatory bowel disease, underlying malignancy, sarcoidosis, or other chronic illness. An extensive medical and laboratory evaluation ( ANA, anti-dsDNA, anti-ENA, ANCA, and Cryoglobulin)was negative . | ||||
 © 2001-2009, DermAtlas | Image Name: | pyoderma_gangrenosum_1_070201 | File Type: | jpg | |
| Diagnosis: | PYODERMA GANGRENOSUM | Category: | cutaneous sign of systemic disease / ulcer | ||
| Body Site: | leg | Age: | 40 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | This biopsy from the edge of the ulcer shows many changes secondary to ulcer formation. There is a brisk inflammatory infiltrate and neovascularization near the ulcer bed. A dense neutrophilic infiltrate is present in this area and extends away from the ulcer. | ||||
| Comments: | This young man developed a small papule which progressed to a nodule and ulcer over several months. He has a history of inflammatory bowel disease, an illness often associated with pyoderma gangrenosum. Histologically, I find this diagnosis unfullfilling as the dermatopathologist often can only say "yes..it could be". Biopsy of the ulcer gives nonspecific secondary changes, and biopsy too far away may only yield normal skin or scarring/repair. Pyoderma gangrenosum is another member of the neutrophilic dermatoses with Sweet syndrome and cellulitis, among others. Clinical-pathologic correlation is required but can usually lead to the correct diagnosis. | ||||
 © 2001-2009, DermAtlas | Image Name: | pyoderma_gangrenousm_1_060126 | File Type: | jpg | |
| Diagnosis: | PYODERMA GANGRENOSUM | Category: | ulcer | ||
| Body Site: | hand | Age: | 42 years | ||
| Contributor: | Franz Ritucci, MD | ||||
| Description: | 0.5-2.5 cm hemorrhagic crusted ulcerated undermined violaceous nodules and plaques | ||||
| Comments: | This 42-year-old woman was supposedly bitten by a spider on her left hand and developed a painful ulcerated plaque several days later. Despite treatment with oral cephalexin the lesions spread locally and to the other hand. A complete medical and laboratory evaluation failed to reveal any underlying disorders, and the lesions resolved with high dose oral corticosteroids. | ||||
 © 2001-2009, DermAtlas | Image Name: | pyoderma_gangrenosum_1_050419 | File Type: | jpg | |
| Diagnosis: | PYODERMA GANGRENOSUM / NEUTROPHILIC DERMATOSIS / INFLAMMATORY BOWEL DISEASE | Category: | cutaneous sign of systemic disease | ||
| Body Site: | leg | Age: | 51 years | ||
| Contributor: | Jessica Ghaferi, BS | ||||
| Description: | multiple2-5 cm violaceous nodules and plaques many with central crusting and ulceration with undermined borders | ||||
| Comments: | This 51-year-old woman with a history of ulcerative colitis, perforated diverticulitis, episcleritis developed red to violaceous tender fluctuant nodules on her legs. Many lesions ruptured and drained sterile seropurulent fluid. She developed a persistently fever and elevated white blood count with a left shift. Numerous blood cultures, urine cultures, and chest X-rays failed to show a source of infection. Biopsies of the leg lesions showed a dermal abscess with overlying mixed and acute chronic inflammation. A second biopsy showed mixed lymphocytic and neutrophilic dermatitis. A third biopsy showed a subcorneal pustular dermatosis. All of these findings were felt to be consistent with pyoderma gangrenosum or an infection, but special stains and cultures revealed no evidence of infection with bacteria, acid fast bacilli or fungi. She improved after 3 days of intravenous immunoglubulin at 35 grams per dose. | ||||
| Related Images: | All related Images pyoderma_gangrenosum_5_050419 pyoderma_gangrenosum_4_050419 pyoderma_gangrenosum_3_050419 pyoderma_gangrenosum_2_050419 | ||||
 © 2001-2009, DermAtlas | Image Name: | pyoderma_gangrenosum_2_050419 | File Type: | jpg | |
| Diagnosis: | PYODERMA GANGRENOSUM / NEUTROPHILIC DERMATOSIS / INFLAMMATORY BOWEL DISEASE | Category: | cutaneous sign of systemic disease | ||
| Body Site: | ankle | Age: | 51 years | ||
| Contributor: | Jessica Ghaferi, BS | ||||
| Description: | violaceous nodules and draining ulcer | ||||
| Comments: | This 51-year-old woman with a history of ulcerative colitis, perforated diverticulitis, episcleritis developed red to violaceous tender fluctuant nodules on her legs. Many lesions ruptured and drained sterile seropurulent fluid. She developed a persistently fever and elevated white blood count with a left shift. Numerous blood cultures, urine cultures, and chest X-rays failed to show a source of infection. Biopsies of the leg lesions showed a dermal abscess with overlying mixed and acute chronic inflammation. A second biopsy showed mixed lymphocytic and neutrophilic dermatitis. A third biopsy showed a subcorneal pustular dermatosis. All of these findings were felt to be consistent with pyoderma gangrenosum or an infection, but special stains and cultures revealed no evidence of infection with bacteria, acid fast bacilli or fungi. She improved after 3 days of intravenous immunoglubulin at 35 grams per dose. | ||||
| Related Images: | All related Images pyoderma_gangrenosum_5_050419 pyoderma_gangrenosum_4_050419 pyoderma_gangrenosum_3_050419 pyoderma_gangrenosum_1_050419 | ||||
 © 2001-2009, DermAtlas | Image Name: | pyoderma_gangrenosum_3_050419 | File Type: | jpg | |
| Diagnosis: | PYODERMA GANGRENOSUM / NEUTROPHILIC DERMATOSIS / INFLAMMATORY BOWEL DISEASE | Category: | cutaneous sign of systemic disease | ||
| Body Site: | sole | Age: | 51 years | ||
| Contributor: | Jessica Ghaferi, BS | ||||
| Description: | tender violaceous nodules | ||||
| Comments: | This 51-year-old woman with a history of ulcerative colitis, perforated diverticulitis, episcleritis developed red to violaceous tender fluctuant nodules on her legs. Many lesions ruptured and drained sterile seropurulent fluid. She developed a persistently fever and elevated white blood count with a left shift. Numerous blood cultures, urine cultures, and chest X-rays failed to show a source of infection. Biopsies of the leg lesions showed a dermal abscess with overlying mixed and acute chronic inflammation. A second biopsy showed mixed lymphocytic and neutrophilic dermatitis. A third biopsy showed a subcorneal pustular dermatosis. All of these findings were felt to be consistent with pyoderma gangrenosum or an infection, but special stains and cultures revealed no evidence of infection with bacteria, acid fast bacilli or fungi. She improved after 3 days of intravenous immunoglubulin at 35 grams per dose. | ||||
| Related Images: | All related Images pyoderma_gangrenosum_5_050419 pyoderma_gangrenosum_4_050419 pyoderma_gangrenosum_2_050419 pyoderma_gangrenosum_1_050419 | ||||
 © 2001-2009, DermAtlas | Image Name: | pyoderma_gangrenosum_4_050419 | File Type: | jpg | |
| Diagnosis: | PYODERMA GANGRENOSUM / NEUTROPHILIC DERMATOSIS / INFLAMMATORY BOWEL DISEASE | Category: | cutaneous sign of systemic disease | ||
| Body Site: | hand | Age: | 51 years | ||
| Contributor: | Jessica Ghaferi, BS | ||||
| Description: | tender violaceous putsules | ||||
| Comments: | This 51-year-old woman with a history of ulcerative colitis, perforated diverticulitis, episcleritis developed red to violaceous tender fluctuant nodules on her legs. Many lesions ruptured and drained sterile seropurulent fluid. She developed a persistently fever and elevated white blood count with a left shift. Numerous blood cultures, urine cultures, and chest X-rays failed to show a source of infection. Biopsies of the leg lesions showed a dermal abscess with overlying mixed and acute chronic inflammation. A second biopsy showed mixed lymphocytic and neutrophilic dermatitis. A third biopsy showed a subcorneal pustular dermatosis. All of these findings were felt to be consistent with pyoderma gangrenosum or an infection, but special stains and cultures revealed no evidence of infection with bacteria, acid fast bacilli or fungi. She improved after 3 days of intravenous immunoglubulin at 35 grams per dose. | ||||
| Related Images: | All related Images pyoderma_gangrenosum_5_050419 pyoderma_gangrenosum_3_050419 pyoderma_gangrenosum_2_050419 pyoderma_gangrenosum_1_050419 | ||||
 © 2001-2009, DermAtlas | Image Name: | pyoderma_gangrenosum_5_050419 | File Type: | jpg | |
| Diagnosis: | PYODERMA GANGRENOSUM / INFLAMMATORY BOWEL DISEASE / NEUTROPHILIC DERMATOSIS | Category: | cutaneous sign of systemic disease | ||
| Body Site: | leg | Age: | 51 years | ||
| Contributor: | Jessica Ghaferi, BS | ||||
| Description: | multiple2-5 cm violaceous nodules and plaques many with central crusting and ulceration with undermined borders | ||||
| Comments: | This 51-year-old woman with a history of ulcerative colitis, perforated diverticulitis, episcleritis developed red to violaceous tender fluctuant nodules on her legs. Many lesions ruptured and drained sterile seropurulent fluid. She developed a persistently fever and elevated white blood count with a left shift. Numerous blood cultures, urine cultures, and chest X-rays failed to show a source of infection. Biopsies of the leg lesions showed a dermal abscess with overlying mixed and acute chronic inflammation. A second biopsy showed mixed lymphocytic and neutrophilic dermatitis. A third biopsy showed a subcorneal pustular dermatosis. All of these findings were felt to be consistent with pyoderma gangrenosum or an infection, but special stains and cultures revealed no evidence of infection with bacteria, acid fast bacilli or fungi. She improved after 3 days of intravenous immunoglubulin at 35 grams per dose. | ||||
| Related Images: | All related Images pyoderma_gangrenosum_4_050419 pyoderma_gangrenosum_3_050419 pyoderma_gangrenosum_2_050419 pyoderma_gangrenosum_1_050419 | ||||
 © 2001-2009, DermAtlas | Image Name: | pyoderma_gangrenosum_1_041024 | File Type: | jpg | |
| Diagnosis: | PYODERMA GANGRENOSUM | Category: | ulcer / cutaneous sign of systemic disease | ||
| Body Site: | foot / ankle | Age: | 30 years | ||
| Contributor: | Kosman Sadek Zikry, MD | ||||
| Description: | punched out undermined ulcers with yellow exudate on a violaceous hyperpigmented fibrotic base | ||||
| Comments: | This 30-year-old man had recurrent painful ulcers of the right ankle which healed with scarring. The clinical course and histologic findings were typical of pyoderma gangrenosum. Cultures were negative for bacteria, atypical mycobacteria, and fungi, and a thorough medical evaluation failed to reveal an associated underlying medical disorder. These ulcers healed with high dose oral steroids. | ||||
| Related Images: | All related Images pyoderma_gangrenosum_3_041024 pyoderma_gangrenosum_2_041024 | ||||
 © 2001-2009, DermAtlas | Image Name: | pyoderma_gangrenosum_2_041024 | File Type: | jpg | |
| Diagnosis: | PYODERMA GANGRENOSUM | Category: | ulcer / cutaneous sign of systemic disease | ||
| Body Site: | foot / ankle | Age: | 30 years | ||
| Contributor: | Kosman Sadek Zikry, MD | ||||
| Description: | punched out undermined ulcers with yellow exudate on a violaceous hyperpigmented fibrotic base | ||||
| Comments: | This 30-year-old man had recurrent painful ulcers of the right ankle which healed with scarring. The clinical course and histologic findings were typical of pyoderma gangrenosum. Cultures were negative for bacteria, atypical mycobacteria, and fungi, and a thorough medical evaluation failed to reveal an associated underlying medical disorder. These ulcers healed with high dose oral steroids. | ||||
| Related Images: | All related Images pyoderma_gangrenosum_3_041024 pyoderma_gangrenosum_1_041024 | ||||
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