Pyoderma Gangrenosum AND Neutrophilic Dermatoses

Meet the patient

A 48-year-old woman with ulcerative colitis is two weeks post laparotomy for a wound that will not heal. The edges are undermined and violaceous, the ulcer is enlarging fast, and the surgical team has debrided it twice — each time it got bigger. She is in severe pain out of proportion to the wound.[1][2]

The registrar orders more antibiotics and books theatre for a skin graft. The examiner's question: "What is happening, and what must you stop doing right now?" This is pyoderma gangrenosum, and debridement is feeding it.[1]

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1. [1]Dissemond J, Marzano AV, Hampton PJ et al. Pyoderma Gangrenosum: Treatment Options Drugs, 2023.PMID 37610614
2. [2]Alavi A, French LE, Davis MD et al. Pyoderma Gangrenosum: An Update on Pathophysiology, Diagnosis and Treatment American journal of clinical dermatology, 2017.PMID 28224502
3. [3]Quist SR, Kraas L Treatment options for pyoderma gangrenosum Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2017.PMID 28140549
4. [4]Jockenhöfer F, Wollina U, Salva KA et al. The PARACELSUS score: a novel diagnostic tool for pyoderma gangrenosum The British journal of dermatology, 2019.PMID 29388188
5. [5]Donnelly H, Boffa MJ Topical treatment of pyoderma gangrenosum: A systematic review Indian journal of dermatology, venereology and leprology, 2025.PMID 39152834
6. [6]Cohen PR Sweet's syndrome--a comprehensive review of an acute febrile neutrophilic dermatosis Orphanet journal of rare diseases, 2007.PMID 17655751
7. [7]Hrin ML, Huang WW Sweet Syndrome and Neutrophilic Dermatosis of the Dorsal Hands Dermatologic clinics, 2024.PMID 38423681
8. [8]Villarreal-Villarreal CD, Ocampo-Candiani J, Villarreal-Martínez A Sweet Syndrome: A Review and Update Actas dermo-sifiliograficas, 2016.PMID 26826881
9. [9]Nelson CA, Stephen S, Ashchyan HJ et al. Neutrophilic dermatoses: Pathogenesis, Sweet syndrome, neutrophilic eccrine hidradenitis, and Behçet disease Journal of the American Academy of Dermatology, 2018.PMID 29653210
10. [10]Tan MG, Tolkachjov SN Treatment of Pyoderma Gangrenosum Dermatologic clinics, 2024.PMID 38423680