A Case of Pyoderma Gangrenosum Responsive to Systemic Corticosteroids

Pyoderma gangrenosum is a rare painful ulcerative disorder of the skin that can prove recalcitrant to treatment. The diagnosis of pyoderma gangrenosum is made based on clinical features after excluding other ulcerative conditions that can present in a similar fashion. We present the case of a 58-year-old woman seen in the hospital for a large nonhealing ulcer present on the lower leg, which was responsive to treatment with systemic corticosteroids. The clinical findings and response to treatment are consistent with a diagnosis of pyoderma gangrenosum. Although many reported cases are associated with an underlying disease process, in this case, no associated condition was detected, despite an extensive work-up. This case describes the essential process of considering other ulcerative disorders in the differential diagnosis when evaluating a possible case of pyoderma gangrenosum, the search for associated underlying conditions, and consideration of treatment options once a diagnosis of pyoderma gangrenosum is made.