Pyoderma gangrenosum: a case report

Pyoderma gangrenosum (PG) is a rare necrotizing, persistent ulcerative cutaneous condition of unknown etiology. We report a 32-year-old female Nigerian with PG. Prior to presentation at the Lagos University Teaching Hospital, she had a skin graft which failed to take and the donor site also healed with great difficulty. She also had a pathergic response at the site of intravenous canulla and delayed wound healing following caesarean section. She had recurrent gastrointestinal (GIT) symptoms and the GIT contrast studies showed duodenal ulcers and diverticulum. Serum electrophoresis did not show a gammopathy. Haematologic parameters showed a leukocytosis but normal differential count, and an elevated ESR 120mm/hr westergreen. The wound eventually healed on high dose prednisolone. The patient was counselled not to subject herself in future to skin graft, biopsy of the wound, nor invasive surgical debridement in case of any recurrence. Keywords : pyoderma gangrenosum, no biopsy, no skin graft Nigerian Medical Practitioner Vol. 49(4) 2006: 85-87