Sir,
A 36-year-old patient with no pathological pathology who presented 6 months before admission pustular lesions increasing in size and number and becoming ulcerated in the legs of centrifugal evolution, painful, without other associated signs including rheumatological digestive or other (Figs.
(a-d) Ulcerations well limited, with raised, erythematous - purplish and inflammatory margins.
Clinical examination revealed multiple ulcers, well limited, purplish, necrotic in center, of varying sizes, the edges was raised with pus. The lesions were in the legs and there were no extra cutaneous manifestations. Biological tests were normal and the histology was in favor of pyoderma gangrenosum. The Idiopathic one was suggested due to exclusion of other usual associations.
The patient was treated by oral corticotherapy with good evolution.
Pyoderma gangrenosum (PG) is a neutrophilic dermatosis with unclear etiology [
PG remains at present a clinical diagnosis of exclusion. The histological aspect reveals most often nonspecific, but helps to exclude other potential causes [
The evocative histology includes a dense and deep dermal infiltrate consisting of neutrophils without vasculitis, associated with a necrotic ulceration appearance, and the treatment remains poorly codified to date. It is mainly based on general or local corticosteroids, immunosuppressors and certain anti-inflammatory antibiotics [
The examination of the patient was conducted according to the Declaration of Helsinki principles.