Pyoderma gangrenosum as a first presentation of inflammatory bowel disease.
Up to 40% of patients with inflammatory bowel disease (IBD) develop an extraintestinal manifestation of the disease with the skin being the most commonly involved organ. Pyoderma gangrenosum (PG), an autoinflammatory non-infectious neutrophilic dermatosis, occurs in 1-2% of patients with IBD. PG can follow a course independent to that of the bowel disease, however, most reported cases describe PG occurring in patients with an established diagnosis of IBD. We present a case of a young patient who presented with axillary skin ulceration, which was subsequently diagnosed as PG. On further investigation for a possible underlying cause, she was found to have Crohn's disease. She had not developed any preceding change in her bowels and did not have abdominal pain; the IBD was diagnosed on endoscopic findings. This case is also unusual for the distribution of the PG lesions that typically occur in the lower limbs.
Department of Gastroenterology, Royal Berkshire Hospital, Reading, UK.
Shahana
S
Shahid
Department of Gastroenterology, Royal Berkshire Hospital, Reading, UK.
Margaret
M
Myszor
Department of Gastroenterology, Royal Berkshire Hospital, Reading, UK.
Aminda
A
De Silva
D003424:Crohn Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D017511:Pyoderma Gangrenosum / Q000209:etiology*; D012812:Sigmoidoscopy; D055815:Young Adult