Pyoderma gangrenosum = Pyoderma gangrenosum

다국어 초록 (Multilingual Abstract)

Pyoderma gangrenosum(PG) is a rare non-infectious inflammatory ulcerative skin disease characterized by sudden onset and rapid progression. The pathogenesis is unknown but may be related to abnormal T cell responses and the production of TNF-α. Beginning as pustules or fluctuant nodules, the lesions ulcerate and have sharply circumscribed violaceous, raised edges in which necrotic pustules may be seen. The PG most commonly occurs on the lower extremities and trunk in adults who are 30 to 50 years old. Majority of cases are associated with systemic disease including inflammatory bowel disease. A 46-year-old healthy Korean woman with no past medical history, visited because of multiple large ulcerative plaques with thick crust and pruritic erythematous papules and patches on her legs. Biopsy was performed on the leg. The histopathologic examination revealed neutrophils and lymphocytes infiltrated crusts with ulcer. On laboratory tests including CBC, Chemistry, CRP, C3, anti-neutrophil cytoplasmic Ab, anti-smooth muscle Ab, anti-RNP, anti-cardiolipin Ab IgG and IgM were unremarkable or negative. Skin culture showed no bacteria. US lower extremities ruled out vasculitis. Approximately 8months later, pruritic erythematous papules and ulcerative plaques were newly found in left arm. Herein, we report an interesting case of pyoderma gangrenosum with multiple extensive ulcerative lesions on the legs without systemic disease so far.