Clinical cases

We present the case of a 65 years old man, with
multiple comorbidities, who reffered to our Dermatology
Clinic for the evaluation, of an oval ulceration, with
erythematous-violet margins, with necrotic base, located at
the level of the left calf. Because the treatment with
dermatocorticoids was ineffective, and considering the
clinical appearance, age and personal history, the clinical
suspicion of pyoderma gangrenosum has been raised. Skin
biopsy was performed with histopathological examination,
which revealed: suppurative neutrophilic infiltrate, fibrosis,
granulation tissue; PAS staining that did not show a fungal
element, thus supporting the diagnosis of pyoderma
gangrenosum. Systemic treatment with dapsone and
corticosteroids was initiated, with favorable evolution.
Pyoderma gangrenosum (PG) is a rare, chronic,
ulcerative skin disease, characterized by rapid progression
to a painful ulcer, with irregular, purple margins. The
diagnosis is established by histopathological examination,
perhaps by excluding other causes of skin ulceration. Also,
the phenomenon of patergia precedes the appearance of the
Managing such patients is extremely difficult, because
they are common and care pathologies are associated with
the number.