Pyoderma Gangrenosum - A Case Report on Surgical Management

Dr. Sanjana A S, Dr. Harshavardhan Gowda, Dr. Sushanth Gowda, Dr Sharavi Budanur

Abstract: Pyoderma gangrenosum is a rare dermatosis of unknown etiology and variable clinical presentation. Pathogenesis includes, neutrophil dysfunction, immune dysregulation and abnormal cytokine signalling by T cells and macrophages. This is the case of a 28 year old female diagnosed with pyoderma gangrenosum. Patient was referred from department of surgery in view of progressive non healing ulcers on dorsum of both feet. A skin biopsy performed from the edge ulcer showed features suggestive of pyoderma gangrenosum with dense dermo-epidermal neutrophilic infiltrate and perivascular lymphocytic infiltrate. Patient received immunosuppressive therapy for 1 month following which she underwent skin grafting. This report highlights the possibility of combining adequate immunosuppressive therapy with skin grafting for a better aesthetic outcome in these patients.

Keywords: Non healing ulcer, immunosuppression, split skin grafting