title: A challenging diagnosis: case report of extensive pyoderma gangrenosum at multiple sites.
abstract: BACKGROUND
  Pyoderma gangrenosum (PG) is a rare dermatological condition characterized by the rapid progression of a painful, necrolytic ulcer with an irregular, undermined border and commonly affects the lower extremities, mainly in the pretibial area. The diagnosis of PG is not easy. Due to lack of diagnostic laboratory test and histopathological findings indicative of PG, it is often misdiagnosed as an infection. This results in delayed or inappropriate treatment of the condition, which leads to devastating consequences such as limb amputation and death.
  
  
  METHODS
  We report a rare case of a 51-year-old female who was initially diagnosed as having infected ulcers and underwent serial debridements, which resulted in extensive PG at three different sites (abdominal, left thigh, and sacral).
  
  
  CONCLUSIONS
  This case highlights the challenges in diagnosing PG, emphasizes the key clinical features to aid diagnosis, and the clinical consequences of delayed or misdiagnosis of this condition.
authors.affiliation: Department of Dermatology, Western Hospital, Footscray, VIC, Australia ; University of Melbourne, Department of Medicine, Dentistry and Health Sciences, Parkville, VIC, Australia.
authors.forename: Mingwei J
authors.initials: MJ
authors.lastname: Ye
authors.affiliation: University of Melbourne, Department of Medicine, Dentistry and Health Sciences, Parkville, VIC, Australia.
authors.forename: Joshua Mingsheng
authors.initials: JM
authors.lastname: Ye
authors.affiliation: Department of Pathology, Western Hospital, Footscray, VIC, Australia.
authors.forename: Leonard
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Plastic Surgery, Western Hospital, Footscray, VIC, Australia.
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Keating
authors.affiliation: Department of Plastic Surgery, Western Hospital, Footscray, VIC, Australia.
authors.forename: Wai-Ting
authors.initials: WT
authors.lastname: Choi
keywords: postoperative complication; skin ulcer; surgical wound
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