Pure bullous pyoderma gangrenosum, a challenging clinico-pathological diagnosis: Critical literature review with emphasis on diagnostic criteria

Pyoderma gangrenosum (PG) is an uncommon, idiopathic, neutrophilic dermatosis characterised by large necrotic ulcers. Occasionally, patients develop atypical presentations, including pustular, bullous, and vegetative lesions. Bullous pyoderma gangrenosum (BPG) is considered an extremely rare form. W...

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Published inIndian journal of dermatology Vol. 67; no. 4; pp. 409 - 414
Main Authors Garcia-Abellas, Patricia, Fernández-Guarino, Montserrat, Díaz-Guimaraens, Borja, Soto-Castillo, Juan, Torres-Jiménez, Javier, Carrillo-Gijón, Rosario
Format Journal Article
LanguageEnglish
Published India Wolters Kluwer India Pvt. Ltd 01.07.2022
Medknow Publications and Media Pvt. Ltd
Medknow Publications & Media Pvt. Ltd
Wolters Kluwer - Medknow
Wolters Kluwer Medknow Publications
Subjects
Antibiotics
Blood cancer
bullous
Care and treatment
Case reports
Dermatopathology Round
haematologic malignancies
Leukemia
Medical diagnosis
Necrotizing fasciitis
neutrophilic dermatosis
Neutrophils
pathergy
Pyoderma
pyoderma gangrenosum
Skin diseases
Ulcers
neutrophilic dermatosis
pyoderma gangrenosum
Bullous
haematologic malignancies
pathergy
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Summary:Pyoderma gangrenosum (PG) is an uncommon, idiopathic, neutrophilic dermatosis characterised by large necrotic ulcers. Occasionally, patients develop atypical presentations, including pustular, bullous, and vegetative lesions. Bullous pyoderma gangrenosum (BPG) is considered an extremely rare form. We describe a case of BPG in a 76-year-old man, with active oncological history, including a recent diagnosis of hairy cell leukemia. Diagnosis of PG was delayed because of atypical clinical presentation that mimicked necrotising fasciitis. The patient was treated with diverse intravenous antibiotics and several surgical procedures. The suspicion of neutrophilic dermatosis arose from the histopathological studies. In the setting of mandatory clinico-pathological correlation, the aim of this report is to point out the morphological characteristics that allow recognition of this uncommon variant of pyoderma gangrenosum.
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ISSN:0019-5154
1998-3611
DOI:10.4103/ijd.ijd_1133_20