Pyoderma gangrenosum — a frequently misdiagnosed skin condition

Alan J Cooper and Frank C Powell
Med J Aust 2013; 199 (6): . || doi: 10.5694/mja13.10655
Published online: 16 September 2013

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

  • 1 Royal North Shore Hospital, Sydney, NSW.
  • 2 Charles Institute of Dermatology, University College Dublin, Dublin, Ireland.


Competing interests:

No relevant disclosures.

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  • 2. Powell FC, Hackett BC, Wallach D. Pyoderma gangrenosum. In: Wolff K, Goldsmith LA, Katz SI, et al, editors. Fitzpatrick’s dermatology in general medicine. 7th ed. New York: McGraw-Hill, 2008: 296-302.
  • 3. Saracino A, Kelly R, Liew D, Chong A. Pyoderma gangrenosum requiring inpatient management: a report of 26 cases with follow up. Australas J Dermatol 2011; 52: 218-221.
  • 4. Reichrath J, Bens G, Bonowitz A, Tilgen W. Treatment recommendations for pyoderma gangrenosum: an evidence-based review of the literature based on more than 350 patients. J Am Acad Dermatol 2005; 53: 273-283.
  • 5. Weenig RH, Davis MD, Dahl PR, Su WP. Skin ulcers misdiagnosed as pyoderma gangrenosum. N Engl J Med 2002; 347: 1412-1418.


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