This post is an answer to the Case – Ulcerative Colitis and Non-Healing Wound
A 44-year-old man presented with bloody diarrhoea and a non-healing, rapidly advancing, painful ulceration wound on his left foot. He had received empirical antibiotics for the previous 2 weeks, with no improvement. The patient had a history of ulcerative colitis, but he discontinued maintenance therapy.
Physical examination revealed a large painful ulcer with an undermined border that was violet and gunmetal grey in colour; the extensor tendons were exposed. Biopsy showed a dense infiltrate of neutrophils in the dermis, acanthosis of the overlying epidermis, and papillary dermal oedema with necrosis. Microbiological cultures and special staining for microorganisms were negative.
A colonoscopy showed severe ulcerative colitis. The diagnosis of ulcerative pyoderma gangrenosum associated with ulcerative colitis was made. Treatment with infliximab was started and negative-pressure dressing was applied. We observed remission of intestinal symptoms and improvement of lesion after only one administration of infliximab.
SIMILAR CASE: Painful Skin Ulcerations
