Pyoderma Gangrenosum

This article is an answer to the Case – Painful Skin Ulcerations

A 5-year-old boy with a history of IgA vasculitis at 2 years of age was admitted to the hospital with a 2-month history of nasal lesions (which were abating) and a 1-month history of progressively painful skin ulcerations.

On examination, the left forearm and right calf had sharply demarcated skin ulcerations with an erythematous base and purple border. The dorsum of the right foot also had a scabbed lesion with an indurated, purple border. The nasal vestibule had areas of scarring but no pustules or ulcers.

A diagnosis of pyoderma gangrenosum was made. After 8 months of treatment with tapering doses of glucocorticoids, the lesions had resolved completely.