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

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.

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References

  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.