Coexistence Of Pyoderma Gangrenosum And Cyclical Cushing’s Syndrome: A Case Report

Abstract

Pyoderma gangrenosum (PG) is a rare, distinctive cutaneous ulceration which is usually idiopathic but may be associated with many systemic diseases which includes inflammatory bowel disease, rheumatoid arthritis, PAPA (pyogenic arthritis, PG & acne) syndrome. We report the association of  PG in a patient with Cushing’s syndrome-an unusual association that does not appear to be widely reported.A 35 year old obese female patient known to have Cushing’s syndrome was admitted with symptoms of breathing difficulty and bilateral all limb blisters. On further investigation she was diagnosed to have classic ulcerative PG, Osteoporosis of spine, anemia and H.pylori infection.PG was confirmed after biopsy with necrotizing vasculitis on the specimens.PG as a clinical diagnosis must be considered in any patient with enlarging, sterile, necrotic lesions even in the absence of known associated systemic diseases. Our patient responded well to the treatment with hydrocortisone, dapsone, ketoconazole adjunct to broad spectrum antibiotics and extensive wound care.