Vol 7, No 1 (2021)
Case report
Published online: 2021-03-17
Get Citation

Pathergy phenomenon leading to the diagnosis of pyoderma gangrenosum

Agata Ossolińska1, Natalia Morawiecka1, Magdalena Żychowska2, Aleksandra Opalińska2, Elżbieta Ostańska3, Adam Reich2
·
Forum Dermatologicum 2021;7(1):12-16.
Affiliations
  1. Students’ Scientific Circle of Experimental Dermatology, Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University
  2. Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University
  3. Department of Pathology, Institute of Medical Sciences, Medical College of Rzeszow University

paid access

Vol 7, No 1 (2021)
CASE STUDY
Published online: 2021-03-17

Abstract

Pyoderma gangrenosum (PG) is a rare skin disease of chronic course and a tendency for recurrence. Pathergy phenomenon, which is characterized by the rapid development of skin lesions at the site of a mechanical trauma, affects about 30% of patients with PG. However, this symptom is not pathognomonic for PG and may develop in other conditions including Behçet’s disease, Sweet syndrome and Crohn’s disease. In the current paper, we present a 25-year-old woman with an infiltrative lesion with a tendency for ulceration located in the interscapular region. Excision of the skin lesion led to the development of infiltration with small ulcerations at the site of surgical intervention. Clinical presentation corresponded to the classical pathergic reaction, which in turn raised the suspicion of PG. Therapy consisted of cyclosporin 5 mg/kg/day and topical ointment with 0.05% of betamethasone and 0.1% of gentamicin. Complete healing was observed after three weeks of treatment. We present the case in order to draw attention to the diagnostic significance of pathergy phenomenon in dermatology.

Abstract

Pyoderma gangrenosum (PG) is a rare skin disease of chronic course and a tendency for recurrence. Pathergy phenomenon, which is characterized by the rapid development of skin lesions at the site of a mechanical trauma, affects about 30% of patients with PG. However, this symptom is not pathognomonic for PG and may develop in other conditions including Behçet’s disease, Sweet syndrome and Crohn’s disease. In the current paper, we present a 25-year-old woman with an infiltrative lesion with a tendency for ulceration located in the interscapular region. Excision of the skin lesion led to the development of infiltration with small ulcerations at the site of surgical intervention. Clinical presentation corresponded to the classical pathergic reaction, which in turn raised the suspicion of PG. Therapy consisted of cyclosporin 5 mg/kg/day and topical ointment with 0.05% of betamethasone and 0.1% of gentamicin. Complete healing was observed after three weeks of treatment. We present the case in order to draw attention to the diagnostic significance of pathergy phenomenon in dermatology.

Get Citation

Keywords

pathergy; pyoderma gangrenosum; Behçet’s disease; needle prick test

About this article
Title

Pathergy phenomenon leading to the diagnosis of pyoderma gangrenosum

Journal

Forum Dermatologicum

Issue

Vol 7, No 1 (2021)

Article type

Case report

Pages

12-16

Published online

2021-03-17

Page views

631

Article views/downloads

43

DOI

10.5603/FD.a2021.0004

Bibliographic record

Forum Dermatologicum 2021;7(1):12-16.

Keywords

pathergy
pyoderma gangrenosum
Behçet’s disease
needle prick test

Authors

Agata Ossolińska
Natalia Morawiecka
Magdalena Żychowska
Aleksandra Opalińska
Elżbieta Ostańska
Adam Reich

References (10)
  1. Wollina U. Pyoderma gangrenosum--a review. Orphanet J Rare Dis. 2007; 2: 19.
  2. Fletcher J, Alhusayen R, Alavi A. Recent advances in managing and understanding pyoderma gangrenosum. F1000Res. 2019; 8.
  3. Powell FC, Schroeter AL, Su WP, et al. Pyoderma gangrenosum: a review of 86 patients. Q J Med. 1985; 55(217): 173–186.
  4. Sequeira FF, Daryani D. The oral and skin pathergy test. Indian J Dermatol Venereol Leprol. 2011; 77(4): 526–530.
  5. Rahman S, Daveluy S. Pathergy test. StatPearls 2020.
  6. Kutlubay Z, Tüzün Y, Wolf R. The Pathergy Test as a Diagnostic Tool. Skinmed. 2017; 15(2): 97–104.
  7. Baker MR, Smith EV, Seidi OA. Pathergy test. Pract Neurol. 2011; 11(5): 301–302.
  8. Ozdemir M, Balevi S, Deniz F, et al. Pathergy reaction in different body areas in Behçet's disease. Clin Exp Dermatol. 2007; 32(1): 85–87.
  9. George C, Deroide F, Rustin M. Pyoderma gangrenosum - a guide to diagnosis and management . Clin Med (Lond). 2019; 19(3): 224–228.
  10. Callen J. Pyoderma gangrenosum. The Lancet. 1998; 351(9102): 581–585.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
phone: +48 58 320 94 94, fax: +48 58 320 94 60, e-mail: viamedica@viamedica.pl