title: Pyoderma gangrenosum with wrist joint destruction: case report.
abstract: Pyoderma gangrenosum (PG) is a rare, noninfectious, neurotrophic dermatosis. We observed a case of PG mimicking cutaneous and osteoarticular infections that presented with a prolonged ulcer on the forearm, severe wrist pain, anemia, substantial local and systemic inflammation as evaluated by serum laboratory data, and carpal osteolysis. Although PG rarely damages joints, the ulcer extended to the joint and destroyed the osteochondral tissues. Advanced ulcerative colitis, which is a most common comorbidity of PG, proved to be an underlying disease. Antibiotic and surgical treatment did not heal the ulcer, which was successfully treated with corticosteroids. This intractable ulcer is often misdiagnosed. Hence when a patient presents with an enlarged, painful, unusual skin lesion, PG should always be considered.
authors.affiliation: Department of Orthopaedic Surgery, Yokohama City University School of Medicine, Yokohama, Japan. hyonmin@hotmail.com
authors.forename: Hyonmin
authors.initials: H
authors.lastname: Choe
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sakano
authors.forename: Hidetake
authors.initials: H
authors.lastname: Takigami
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Inaba
authors.forename: Kosuke
authors.initials: K
authors.lastname: Matsuo
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Saito
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001706:Biopsy; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D003113:Colonoscopy; D003646:Debridement; D003951:Diagnostic Errors; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D014955:Wrist Joint / Q000473:pathology / Q000601:surgery*
chemical_list: D000305:Adrenal Cortex Hormones