title: [Ganulomatosis with polyangiitis revealed by a cutaneous ulceration mimicking a pyoderma gangrenosum: Two patients].
abstract: BACKGROUND
  Granulomatosis with polyangiitis is a systemic and necrotizing vasculitis, and cutaneous involvement is uncommon. We report two cases of skin ulceration mimicking a pyoderma gangrenosum, and revealing granulomatosis with polyangiitis.
  
  
  METHODS
  We report two patients who presented with atypical cutaneous ulcerations, with a chronic course. These wounds were large ulcerations with abrupt edges, with purulent and hemorrhagic exudates. The first hypothesis was a pyoderma gangrenosum, but the biopsies were not specific. New biopsies performed distant from the edges showed a necrotizing vasculitis associated with giant cells granuloma, typical from granulomatosis with polyangiitis.
  
  
  CONCLUSIONS
  Cutaneous manifestations are uncommon in granulomatosis with polyangiitis, and can be misleading as they may precede the systemic symptoms. We report two cases of granulomatosis with polyangiitis revealed by cutaneous symptoms mimicking a pyoderma gangrenosum. Repetition of the skin biopsies were necessary to obtain the diagnosis.
authors.affiliation: Service de dermatologie, hôpitaux civils de Colmar, 68024 Colmar, France. Electronic address: ghislaine.decambourg@ch-colmar.fr.
authors.forename: G
authors.initials: G
authors.lastname: de Cambourg
authors.affiliation: Service de dermatologie, hôpitaux civils de Colmar, 68024 Colmar, France.
authors.forename: A
authors.initials: A
authors.lastname: Mahé
authors.affiliation: Service de dermatologie, hôpitaux civils de Colmar, 68024 Colmar, France.
authors.forename: S
authors.initials: S
authors.lastname: Banea
authors.affiliation: Service d'anatomie pathologique, hôpitaux civils de Colmar, 68024 Colmar, France.
authors.forename: C
authors.initials: C
authors.lastname: Moulinas
authors.affiliation: Service de médecine interne, hôpitaux civils de Colmar, 68024 Colmar, France.
authors.forename: G
authors.initials: G
authors.lastname: Blaison
mesh_terms: D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000175:diagnosis*; D012867:Skin / Q000473:pathology*; D012883:Skin Ulcer / Q000175:diagnosis*
keywords: Granulomatose avec polyangéite; Granulomatosis with polyangiitis; Maladie de Wegener; Plaie cutanée; Pyoderma gangrenosum; Skin wound; Wegener's granulomatosis