Atypical pyoderma gangrenosum in a patient with osteomyelofibrosis.
BACKGROUND
Atypical forms of pyoderma gangrenosum generally appear on the upper extremities; most frequently they are associated with myeloproliferative disorders, including osteomyelofibrosis. A response to systemic steroids is more pronounced than in classical form. Sometimes it may be the first sign of an underlying malignancy.


METHODS
We reported a patient with atypical pyoderma gangrenosum developed during the course of a myeloid malignancy--osteomyelofibrosis. The lesions occurred after a minor trauma. Painful blistering plaques, with an elevated, bluish-gray border were located on the dorsal aspect of hands. No skin malignancy was found. The lesions resolved rapidly to systemic steroids.


CONCLUSIONS
Considering the unusual clinical presentation which makes the diagnosis difficult, as well as the fact that atypical forms of pyoderma gangrenosum can be the first sign of malignancies, especially myeloproliferative ones, recognizing this entity enables timely guiding future investigations toward their prompt detection.
Clinical Center of Serbia, Institute of Dermatology and Venereology, Belgrad, Serbia.
Dubravka
D
Zivanović
Srdan
S
Tanasilović
Dusan
D
Skiljević
Maja
M
Tomović
Andrija
A
Bogdanović
Sonja
S
Vesić
Ljiljana
L
Medenica
D000368:Aged; D006229:Hand Dermatoses / Q000150:complications / Q000473:pathology; D006801:Humans; D008297:Male; D055728:Primary Myelofibrosis / Q000150:complications*; D017511:Pyoderma Gangrenosum / Q000150:complications / Q000473:pathology*; D012867:Skin / Q000469:parasitology