When a wound is the harbinger of a serious underlying systemic illness.

A 55-year-old woman presented with progressive enlarging and painful non-healing ulcers on her bilateral lower extremities; biopsy was consistent with pyoderma gangrenosum. Workup for an underlying illness revealed a cavitary lung nodule and an ulcerating mass in the anal canal. Patient did not have...

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Bibliographic Details
Published in:BMJ Case Reports Vol. 2018; pp. 1 - 5
Main Authors: Kishore, Shweta, Mittal, Varun, Ahuja, Shradha, Majithia, Vikas
Format: Journal Article
Published: BMJ Publishing Group 1/31/2018
Online Access:View this record in EBSCOhost
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      dt: 1/31/2018
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      pub: BMJ Publishing Group
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        127755655
        10.1136/bcr-2017-222491
        127755655
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        atl: When a wound is the harbinger of a serious underlying systemic illness.
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          Kishore, Shweta
          Mittal, Varun
          Ahuja, Shradha
          Majithia, Vikas
        affil: Department of Rheumatology, University of Mississippi Medical Center, Jackson, Mississippi, USA
      sug:
      ab: A 55-year-old woman presented with progressive enlarging and painful non-healing ulcers on her bilateral lower extremities; biopsy was consistent with pyoderma gangrenosum. Workup for an underlying illness revealed a cavitary lung nodule and an ulcerating mass in the anal canal. Patient did not have any respiratory or gastrointestinal symptoms. Differential diagnosis included inflammatory bowel disease, rectal carcinoma or infection such as tuberculosis, fungal process. Histopathology did not reveal any malignancy, inflammatory bowel disease or infection. Serological studies were positive for perinuclear antineutrophil antibodies specific to proteinase-3 antigen, and the patient was ultimately diagnosed with granulomatosis with polyangiitis. Intravenous pulse dose steroids were initiated followed by monthly pulse cyclophosphamide for 6 months, resulting in rapid and significant improvement of the wounds.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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