title: Pulmonary pyoderma gangrenosum without cutaneous manifestations.
abstract: Pyoderma gangrenosum is a chronic sterile skin disorder that is frequently seen in association with systemic disorders such as inflammatory bowel disease. Extracutaneous pyoderma gangrenosum is rare and most commonly occurs in the lungs. It is particularly unusual for extracutaneous pyoderma gangrenosum to manifest prior to skin findings and without an associated systemic disorder. A 19-year-old white man presented with shortness of breath and a productive cough. His skin exam was normal. Unenhanced chest computed tomography showed peripheral consolidations, areas of cavitation, nodules and bilateral pleural effusions. A bronchoalveolar lavage and an autoimmune panel were unremarkable. Right lung wedge biopsies via thoracostomy was performed and showed pulmonary pyoderma gangrenosum. He was treated with corticosteroids and has returned back to his baseline. This is the first case of pulmonary pyoderma gangrenosum without any associated underlying systemic disorder and without any cutaneous manifestations to date. Serial follow-ups are necessary to assess for the development of an associated systemic disorder or skin lesions.
authors.affiliation: Department of Internal Medicine, Division of Pulmonary Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA.
authors.forename: Kenneth Kazuto
authors.initials: KK
authors.lastname: Sakata
authors.affiliation: Department of Internal Medicine, Division of Pulmonary Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Penupolu
authors.affiliation: Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
authors.forename: Thomas Vail
authors.initials: TV
authors.lastname: Colby
authors.affiliation: Department of Radiology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
authors.forename: Michael Bruce
authors.initials: MB
authors.lastname: Gotway
authors.affiliation: Department of Internal Medicine, Division of Pulmonary Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA.
authors.forename: Lewis Jon
authors.initials: LJ
authors.lastname: Wesselius
mesh_terms: D001706:Biopsy; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D017511:Pyoderma Gangrenosum / Q000175:diagnosis* / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011241:Prednisone
keywords: extracutaneous pyoderma gangrenosum; granulomatosis with polyangiitis; inflammatory bowel disease; pulmonary pyoderma gangrenosum