Successful low-dose corticosteroid treatment of aggressive pyoderma gangrenosum with irritable bowel syndrome: a case report

Abstract

Pyoderma gangrenosum (PG) is a rare and chronic cutaneous disorder characterized by painful ulcers that progresses rapidly. The disease is thought to be immune-mediated. However, the exact etiopathogenesis of the disease has yet to be clearly established. The disease is often misdiagnosed as other cutaneous disorders, most notably infections such as cellulitis in its initial stage. Failure of antibiotic treatment is one of the signs when a diagnosis of PG should be considered. Due to its rampant lesion evolution, aggressive corticosteroid therapy has long been used as the mainstay treatment for PG. However, this can lead to side effects such as gastrointestinal bleeding, especially in patients with autoimmune diseases such as inflammatory bowel disease (IBD). We report the case of a 54-year-old female patient with PG that was initially misdiagnosed as cellulitis and furunculosis along with IBD. She was treated using a low-dose regimen of methylprednisolone, which resulted in significant clinical improvement and complete resolution after 2 months of therapy.

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