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Pyoderma gangrenosum: Three Cases Report and Literature Review


Authors: Z. Sroková 1;  S. Urbanček 1;  J. Janek 2
Authors‘ workplace: Dermatovenerologická klinika SZU, Banská Bystrica 1;  Klinika cievnej a transplantačnej chirurgie SZU, Banská Bystrica 2
Published in: Čes-slov Derm, 101, 2026, No. 3, p. 140-148
Category: Case interpretation

Overview

Pyoderma gangrenosum (PG) is an immune-mediated, autoinflammatory, non-infectious skin disorder belonging to the spectrum of neutrophilic dermatoses, characterised by a variable clinical presentation. The authors provide an overview of the disease and present case reports of three patients with PG. In two patients, the disease was associated with ulcerative colitis with favourable response to immunosuppressive therapy. In the third patient, presenting with multiple PG lesions in combination with a paravertebral abscess collection, the possibility of extracutaneous involvement or a Para infectious aetiology was considered, with a favourable response to combined immunosuppressive and antibiotic therapy. The aim of this study is to highlight the variability of the clinical presentation, which may lead to misdiagnosis, and to emphasise the importance of a multidisciplinary approach in patient management.

Keywords:

differential diagnosis – pyoderma gangrenosum – neutrophilic dermatosis – multidisciplinary management


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Dermatology & STDs Paediatric dermatology & STDs
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