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Pyoderma gangrenosum associated with limited cutaneous systemic sclerosis: a rare case with literature review

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Abstract

Pyoderma gangrenosum (PG) is a skin disease characterized by painful ulcers that, when not appropriately treated, can lead to permanent disfigurement. Pyoderma gangrenosum has been observed in a multitude of autoimmune disorders such as rheumatoid arthritis, inflammatory bowel disease (IBD), and sarcoidosis (Feld et al. J Rheumatol. 39(1):197, 2012; Herrero et al. J Rheumatol. 36:7:1557–1558, 2009). It is rarely associated with autoimmune disorders such as systemic sclerosis. We report a case of a patient with known limited cutaneous systemic sclerosis who developed an ulcerated lesion on the 2nd digit of the left hand. The lesion was initially thought to be cellulitis and the patient underwent superficial wound debridement. Postoperatively, the patient’s lesions worsened. The patient was treated with intravenous (IV) methylprednisolone and 0.05% topical clobetasol due to high suspicion for PG with complete resolution of ulcerated lesions and minimal scarring.

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Authors and Affiliations

  1. Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA

    Maria Skopis & Barbara Pociurko

  2. Department of Medicine, Division of Rheumatology, Allergy and Immunology, SUNY Stony Brook University Hospital, Stony Brook, NY, USA

    Ahmed Aly Elghawy & Ayse Bag-Ozbek

  3. Department of Pathology, Mount Sinai Medical Center, Miami Beach, FL, USA

    Kei Shing Oh

  4. Veterans Administration Medical Centers, Northport, NY, USA

    Ayse Bag-Ozbek

Authors
  1. Maria Skopis
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  2. Ahmed Aly Elghawy
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  3. Barbara Pociurko
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  4. Kei Shing Oh
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  5. Ayse Bag-Ozbek
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Contributions

The case was diagnosed and followed by Barbara Pociurko. Maria Skopis, Ahmed Aly Elghawy, and Ayse Bag-Ozbek conceived and planned the case report. Maria Skopis, Ahmed Aly Elghawy, Barbara Pociurko, and Ayse Bag-Ozbek contributed to writing the manuscript, as well as performing the literature data search and analysis. Kei Shing Oh contributed to reading, capturing, and describing the histologic features pertaining to the case report. The final version was read, corrected, and approved by Maria Skopis, Ahmed Aly Elghawy, Barbara Pociurko, and Ayse Bag-Ozbek.

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Correspondence to Maria Skopis.

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A written informed consent was obtained from the patient for publication of this case report and any accompanying images.

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Skopis, M., Elghawy, A.A., Pociurko, B. et al. Pyoderma gangrenosum associated with limited cutaneous systemic sclerosis: a rare case with literature review. Clin Rheumatol 40, 1141–1145 (2021). https://doi.org/10.1007/s10067-020-05285-z

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  • DOI: https://doi.org/10.1007/s10067-020-05285-z

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