title: [Deep-seated granulomatous pyoderma gangrenosum: A novel variant?].
abstract: BACKGROUND
  We report an extremely rare case of pyoderma gangrenosum with the clinical features of pyoderma gangrenosum but with unusual histopathological findings and deep massive granulomatous infiltration through the dermis.
  
  
  METHODS
  A 15-year-old girl presented with a two-month history of deep ulcers on the lower legs and forehead. She also presented abdominal pain with diarrhea and vomiting that disappeared after symptomatic treatment. Histology showed extensive granulomatous infiltration in the dermis and hypodermis and a micro-abscess in the dermis. An abdominopelvic CT scan revealed peritoneal fluid and tissue formation in a lateral carotid cave (6.56 cm/4.56 cm). Colonoscopy was normal. The patient was treated with oral prednisone, resulting in resolution of the problems of cutaneous lesions, peritoneal fluid and tissue formation.
  
  
  CONCLUSIONS
  Our case involves a rare presentation of pyoderma gangrenosum (PG) inconsistent with any of the four clinical variants of PG and characterized histologically by the presence of deep granulomas in the dermis and hypodermis. Despite the atypical clinical presentation and unusual histopathological findings, PG seemed the most likely diagnosis after infectious diseases had been ruled out; the good outcome achieved with oral corticosteroids supported our diagnosis.
authors: Service de dermatologie et de vénéréologie, CHU Ibn Rochd, rue Lahcen Laarjoune, 20000 Casablanca, Maroc. Electronic address: kenzabaline@gmail.com.
authors: K
authors: K
authors: Baline
authors: Service de dermatologie et de vénéréologie, CHU Ibn Rochd, rue Lahcen Laarjoune, 20000 Casablanca, Maroc.
authors: K
authors: K
authors: Khadir
authors: Service de dermatologie et de vénéréologie, CHU Ibn Rochd, rue Lahcen Laarjoune, 20000 Casablanca, Maroc.
authors: S
authors: S
authors: Chiheb
authors: Service d'anatomopathologie, CHU Ibn Rochd, rue Lahcen Laarjoune, 20000 Casablanca, Maroc.
authors: F
authors: F
authors: Marnissi
authors: Service de dermatologie et de vénéréologie, CHU Ibn Rochd, rue Lahcen Laarjoune, 20000 Casablanca, Maroc.
authors: H
authors: H
authors: Benchikhi
mesh_terms: D000038:Abscess / Q000473:pathology; D000293:Adolescent; D001202:Ascitic Fluid / Q000000981:diagnostic imaging; D020405:Dermis / Q000473:pathology*; D005260:Female; D006099:Granuloma / Q000473:pathology*; D006801:Humans; D017511:Pyoderma Gangrenosum / Q000473:pathology*; D011859:Radiography; D040521:Subcutaneous Tissue / Q000473:pathology*
keywords: Abcès aseptique; Aseptic abscess; Dermatose neutrophilique; Granulomes; Neutrophilic dermatoses; Pyoderma gangrenosum; Pyoderma granulomateux superficiel; Superficial pyoderma gangrenosum