A case of vegetative pyoderma gangrenosum

A 55-year-old Chinese man presented with a 17-month history of pustules, papules, nodules, plaques, and ulcers involving most of his body, including the scalp, face, neck, trunk, and extremities. Several superficial ulcers with vegetative exophytic margins and plaques were also present. Cribriform sinuses were on the plaque surfaces and ulcer bases. Pus discharged under pressure. C-reactive protein level was 120.07 mg/dL, with the erythrocyte sedimentation rate at 95 mm/h. Repeated smears and cultures were negative. Forearm incisional biopsy showed pseudoepitheliomatous hyperplasia and diffuse neutrophilic infiltration with microabscesses. Vegetative pyoderma gangrenosum was diagnosed. Lesions markedly abated after systemic corticosteroid therapy. Copyright (C) 2015, Taiwanese Dermatological Association. Published by Elsevier Taiwan LLC. All rights reserved.