Hidden in Plain Sight: A Case Series of Inflammatory Bowel Disease With Dermatologic Lesions As Initial or Concurrent Manifestations

Pyoderma gangrenosum (PG) and erythema nodosum (EN) are rare skin conditions associated with inflammatory bowel disease (IBD), with increasing incidence as the disease progresses. We describe three cases of newly diagnosed IBD with cutaneous extraintestinal manifestations (EIMs) at the time of diagnosis. Three previously healthy patients presented with bloody diarrhea and concomitant nodular and ulcerating skin lesions at the onset of diarrhea. Dermatopathology showed PG and EN with endoscopic confirmation of ulcerative colitis. Clinical improvement was achieved with steroids and biological agents. These cases display the importance of a proper review of symptoms and a detailed workup of dermatological lesions prior to assuming infectious etiology.

Postoperative Pyoderma Gangrenosum Following Carpal Tunnel Surgery: A Case Report and Review of the Literature

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterized by painful ulcerated lesions. Postoperative PG, which typically begins with erythema and severe pain within two weeks after surgery, progresses into ulcerated lesions. It is often misdiagnosed as it resembles necrotizing skin infections, resulting in delayed treatment. Cases of postoperative PG located in the upper extremity are uncommon. In this case report, we discuss a male patient who developed postoperative PG after carpal tunnel surgery.

A Case Report of Localized Vegetative Pyoderma Gangrenosum of the Foot in a Patient With Myasthenia Gravis in an Outpatient Setting

Pyoderma gangrenosum (PG) is a reactive, non-infectious inflammatory neutrophilic dermatoses that have historically presented as a diagnostic and therapeutic dilemma. It is often misdiagnosed as other disease processes, particularly ulcers, and is thus associated with a delay in care. Pyoderma gangrenosum, left untreated, carries a three times mortality risk compared to the general population. There are multiple subtypes and presentations reflected in the current research which shows that there is still much to be understood about this disorder. Here we examine the unique presentation of a vegetative type of pyoderma gangrenosum through the case of a 69-year-old male that presents with a persistent lesion on his foot.

Treatment of Pyoderma Gangrenosum With Mycophenolate and Hyperbaric Oxygen Therapy: A Case Report and Literature Review

Pyoderma gangrenosum is an uncommon inflammatory ulcerative skin disorder with an unclear etiology. In many cases, it is associated with several underlying systemic diseases, with inflammatory bowel disease being the most common one. Since it does not have any specific clinical or laboratory findings, it is a diagnosis of exclusion. A multidisciplinary approach is vital in treating pyoderma gangrenosum. Its recurrence remains common, and it also has an unpredictable prognosis. Here, we report a case report of pyoderma gangrenosum, which was successfully treated with mycophenolate and hyperbaric oxygen therapy.

From the Deep: Overlap of Neutrophilic Dermatoses Disorders Associated With Acute Myeloid Leukemia

We report the case of a man in his 50s with refractory acute myelomonocytic leukaemia (AML) who presented with neck swelling, fever, and elevated levels of C-reactive protein (CPR) after venous punctures. An infected haematoma was presumed, but the patient showed no signs of improvement under broad-range antibiotics, and microbiological results were negative. The subsequent development of a rapidly evolving erythematous-violaceous plaque around a site that had previously punctured on the extensor surface of the right arm prompted us to reconsider the clinical setting as a whole and consider the hypothesis of deep neutrophilic dermatosis (ND) associated with haematologic malignancy. A biopsy of the arm lesion showed an aseptic neutrophilic infiltrate, confirming this diagnosis. The patient was initially treated with high-dose intravenous corticosteroids, resulting in a dramatic improvement of the skin lesions.

Recurrence of Pyoderma Gangrenosum Potentially Triggered by COVID-19 Vaccination

Pyoderma gangrenosum (PG) is a rare inflammatory skin disease of unknown origin. As with other vaccines, COVID-19 vaccines have been associated with many cutaneous reactions. Although COVID-19 vaccination is crucial, it is important for dermatologists and other physicians to be aware of the possible cutaneous reactions that can occur following COVID-19 vaccination. In this report, we describe a 73-year-old woman with a personal history of PG who experienced a recurrence after receiving her second dose of the tozinameran vaccine. Although extremely rare, flares of other inflammatory dermatoses, including lichen planus, have been reported following COVID-19 vaccination. Here we discuss the overlap in pathogenesis of PG and COVID-19, proposing possible mechanisms behind this rare phenomenon.

Pyoderma Gangrenosum Associated With Seronegative Arthritis: A Rural Tertiary Care Experience

Pyoderma gangrenosum (PG) is a rare ulcerating inflammatory skin condition, the cause of which remains idiopathic. A 35-year-old female presented to our outpatient department (OPD) with initial findings of multiple non-healing ulcers that developed suddenly with a symmetric bilateral pattern on the dorsal aspect of hands, elbows, and inner knees. Lesions initially developed as a pustule that progressed to burst and leave behind a raw area that turned into an ulcer. Polyarthralgia preceded these symptoms. Extensive investigations were done for the varied differentials that were postulated; this led to finally declaring PG associated with seronegative arthritis as a diagnosis of exclusion. Initial treatment with antibiotics showed little results, and thus, the patient was started on a systemic corticosteroid which proved to be successful.