Pyoderma gangrenosum — a frequently misdiagnosed skin condition

Pyoderma gangrenosum is a skin condition that causes significant morbidity because of delays in diagnosis and consequent delays in treatment

Pyoderma gangrenosum (PG) is a painful destructive skin condition, which often presents as progressive deep ulcerations or superficial bullous erosions. It frequently causes significant morbidity because of delays in diagnosis and consequent delays in instituting effective treatments. A recent case report from the United Kingdom highlights a sequence of events that is repeated with often devastating consequences.1 The report describes a woman who re-presented to the hospital 2 weeks after a laparoscopic abdominal-approach perineal hernia repair with severe abdominal pain and oozing from a wound site, and was treated for cellulitis. Antibiotics were continued despite progression of the lesion and negative cultures. Only when the situation progressed to “an ulcerating, macerated, hyperalgesic lesion involving the entire anterior abdominal wall”, was a dermatologist contacted, the correct diagnosis made, and the appropriate treatment instituted.1