title: Pyoderma gangrenosum severely affecting both hands.
abstract: We report a case of pyoderma gangrenosum affecting both hands simultaneously. Pyoderma gangrenosum affecting the hands is an extremely rare condition which may result in considerable tissue destruction. Management includes immunosuppressant therapy, treatment of associated medical conditions and minimal surgical intervention. Despite a high maintenance dose of corticosteroid and adequate control of coexisting ulcerative colitis and rheumatoid arthritis, tissue destruction in the hands spread rapidly in our patient. The key to the patient's dramatic improvement was the tissue biopsy suggesting pyoderma gangrenosum and the subsequent treatment with the cytotoxic immunosuppressant, azathioprine.
authors.affiliation: Department of Orthopaedic Surgery, Queen Margaret Hospital Dunfermline, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Adam
authors.forename: I
authors.initials: I
authors.lastname: Nawroz
authors.forename: P W
authors.initials: PW
authors.lastname: Petrie
mesh_terms: D000671:Amputation, Surgical; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis; D001379:Azathioprine / Q000008:administration & dosage; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000150:complications / Q000175:diagnosis; D003646:Debridement; D003937:Diagnosis, Differential; D005260:Female; D006225:Hand / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000473:pathology / Q000601:surgery*; D012867:Skin / Q000473:pathology
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine