title: Fatal case of vulvar pyoderma gangrenosum with pulmonary involvement: case presentation and literature review.
abstract: BACKGROUND
  We report a case of a 61-year-old woman with locally destructive vulvar pyoderma gangrenosum (PG) with pulmonary involvement who was refractory to numerous systemic therapies and developed complications resulting in her demise.
  
  
  OBJECTIVE
  To report a rare case of treatment-resistant vulvar PG with pulmonary involvement that proved to be fatal.
  
  
  METHODS
  PubMed was used to search for other reports that discuss PG, or more specifically perigenital PG, with pulmonary involvement.
  
  
  CONCLUSIONS
  A thorough review of the literature revealed 33 cases of PG with pulmonary involvement, with only 4 involving the perigenital region. We report the second case of a female with vulvar PG and pulmonary involvement. In contrast to the first case described, our patient did not respond to systemic therapy, and, ultimately, her disease was fatal. It is hoped that with continued documentation of this rare and potentially lethal presentation of PG, physicians will determine more effective treatments.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Mercer
authors.forename: Paul
authors.initials: P
authors.lastname: Kuzel
authors.forename: Muhammad N
authors.initials: MN
authors.lastname: Mahmood
authors.forename: Alain
authors.initials: A
authors.lastname: Brassard
mesh_terms: D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000209:etiology*; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000150:complications* / Q000175:diagnosis; D014845:Vulvar Diseases / Q000209:etiology*