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Pyoderma Gangrenosum — RACP Adult Medicine MCQ

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ModerateRheumatologyPyoderma GangrenosumRACP Adult Medicine

A 45-year-old woman with inflammatory bowel disease presents with a painful, rapidly enlarging ulcer on the lower leg with violaceous undermined borders. Wound swabs are negative. Biopsy shows sterile neutrophilic infiltrate. What is the most likely skin manifestation?

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Correct answer: E — Pyoderma gangrenosum

Painful ulcer with violaceous undermined borders, sterile neutrophilic infiltrate, and IBD association is pyoderma gangrenosum. Pathergy is a feature — surgical debridement worsens the lesion. Treatment: high-dose corticosteroids ± ciclosporin or infliximab. May also occur in haematological malignancies, RA, and hepatitis C.

Reference: eTG Dermatology – 2024 – Pyoderma Gangrenosum