Wegener's granulomatosis presenting as pyoderma gangrenosum.
Half of the patients with Wegener's granulomatosis develop skin lesions due to the systemic vasculitis. Wegener's granulomatosis should be included in the differential diagnostic considerations for necrotic ulcers, including leg ulcers. We present a case which demonstrates the importance of histological evaluation of a skin biopsy from the margin of the ulcer for establishing the diagnosis. Antineutrophil cytoplasmic antibodies with antigen specificity for proteinase 3 (PR3-ANCA) were detected supporting the diagnosis of Wegener granulomatosis. Further evaluation showed involvement of the eyes and kidneys. The ulcer rapidly healed under treatment with cyclophosphamide and corticosteroids.
Boudny
Clara
C
Clinic and Polyclinic for Dermatology, Inselspital, University of Bern, Switzerland. clara.boudny@ksa.ch
Nievergelt
Helga
H
Braathen
Lasse R
LR
Simon
Dagmar
D
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000473:pathology*; D006801:Humans; D007871:Leg Ulcer / Q000473:pathology*; D017511:Pyoderma Gangrenosum / Q000473:pathology*