Pyoderma gangrenosum as a manifestation of multisystem autoimmunity in a patient with giant cell arteritis, optic neuritis and rheumatoid arthritis.

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis typically associated with autoimmune disease; however, its coexistence with giant cell arteritis (GCA) and optic neuritis is exceedingly uncommon and rarely reported. We describe a woman in her early 70s with rheumatoid arthritis and recent...

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Publicado en:BMJ Case Reports Vol. 19; no. 6; pp. 1 - 5
Autores principales: Aftab, Gohar, Tabassum, Saadia, Fatima, Saira, Ali, Saman
Formato: Journal Article
Publicado: BMJ Publishing Group Jun2026
Acceso en línea:Ver este registro en EBSCOhost
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        10.1136/bcr-2025-271851
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        atl: Pyoderma gangrenosum as a manifestation of multisystem autoimmunity in a patient with giant cell arteritis, optic neuritis and rheumatoid arthritis.
      aug:
        au:
          Aftab, Gohar
          Tabassum, Saadia
          Fatima, Saira
          Ali, Saman
        affil: Dermatology, The Aga Khan University Hospital, Karachi, Pakistan.
      sug:
      ab: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis typically associated with autoimmune disease; however, its coexistence with giant cell arteritis (GCA) and optic neuritis is exceedingly uncommon and rarely reported. We describe a woman in her early 70s with rheumatoid arthritis and recently diagnosed GCA who developed painful breast ulcers while on tapering systemic corticosteroids for GCA, shortly after a herpes zoster infection. The ulcers showed classic PG morphology and fulfilled Delphi diagnostic criteria. She had preceding MRI-confirmed bilateral optic neuritis followed by bilateral temporal arteritis. Intralesional corticosteroid therapy resulted in complete ulcer healing within 1month. This case highlights an unusual constellation of PG, GCA, rheumatoid arthritis and optic neuritis, with herpes zoster as a potential pathergic trigger. It emphasises the importance of considering PG in atypical ulceration occurring in patients with multisystem autoimmunity, even when lesions develop despite ongoing low-dose systemic corticosteroid therapy.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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