Pyoderma gangrenosum: combination therapy with excellent results in a patient with underlying hepatitis C

Description

Pyoderma gangrenosum (PG) is defined as a neutrophilic dermatosis, not related to any infections or gangrenous causes.1 It usually appears with an underlying systemic disease. We report a 55-year-old man who presented with painful bilateral skin lesions on legs with no associated constitutional symptoms. Patient had a history of untreated hepatitis C infection with negative cryoglobulinaemia screen. Surgical debridement was performed in the emergency department, at that time without a diagnosis and a biopsy plus culture of the skin was done which disclosed no evidence of microorganism, vasculitis findings and perivascular lymphoplasmacytic infiltrate. A repeat biopsy showed neutrophilic infiltrate. Clinical and histopathological diagnosis of PG was made and patient was started on intravenous steroids with some improvement,2 followed with clinical deterioration that prompted intravenous immunoglobulin therapy with excellent results.3 Patient continues to get weekly wound care and was being seen by infectious disease and rheumatology...

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