title: Wegener's granulomatosis presenting as pyoderma gangrenosum.
abstract: A 59-year-old male patient developed a necrotizing ulceration on the right shin. Both clinical and histopathologic examinations suggested pyoderma gangrenosum. After temporary improvement of skin symptoms under peroral glucocorticoid treatment, a hemorrhagic-purulent discharge started from the nose, he began to have fever, malaise, cough, and a chest X-ray revealed inflammation in the lung. Cerebral CT and MRI disclosed midline bone loss within the nasal septum and granulomatosus tissue masses protruding into the right orbit. The c-ANCA test was positive, serum IgA was elevated, and he had microhaematuria and proteinuria. In this severe case of Wegener's granulomatosis prolonged methylprednisone and cyclophosphamide treatment was initiated. Both the skin symptoms and the granulomatosus infiltrations resolved.
authors.affiliation: Department of Dermato-Venereology, Semmelweis University, Budapest, Hungary.
authors.forename: Hajnal Irén
authors.initials: HI
authors.lastname: Szõcs
authors.forename: Katalin
authors.initials: K
authors.lastname: Torma
authors.forename: Edina
authors.initials: E
authors.lastname: Petrovicz
authors.forename: Judit
authors.initials: J
authors.lastname: Hársing
authors.forename: György
authors.initials: G
authors.lastname: Fekete
authors.forename: Sarolta
authors.initials: S
authors.lastname: Kárpáti
authors.forename: Attila
authors.initials: A
authors.lastname: Horváth
mesh_terms: D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000209:etiology* / Q000473:pathology / Q000628:therapy