182 Pyoderma gangrenosum
Diagnosis
These are necrotic ulcers (lesions), which are a feature of pyoderma gangrenosum (aetiology); I would like to investigate for underlying inflammatory bowel disease.
Questions
What are the variants of this condition?
Variants have been described based on the location of the lesion or the associated process, the skin lesion being similar to the classical pyoderma gangrenosum:
• Peristomal pyoderma gangrenosum at site of ileostomy (Fig. 182.2) or colostomy in ulcerative colitis or Crohn’s disease
• Penile or scrotal in adolescent adults
• Associated with preleukaemic state (the ulcer is shallow with bullous blue-grey border)
• Pyostomatitis vegetans is an oral variant with chronic pustular and eventually vegetative lesions in the mucous membrane of the mouth.
Fig. 182.2 Pyoderma gangrenosum at ileostomy site.
(With permission from Ennis et al. 2001 pp. 533.)
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