Urgent treatment required for ulcer
The history helped confirm the diagnosis in this case. The ulcer was painful and of sudden onset. It was made worse by biopsying the edge and by regular debriding. The patient had a previous history of ulcerative colitis (UC) treated about 15 years before. Recently she had a recurrence of symptoms suggesting a flare of her UC.
Pyoderma gangrenosum is a neutrophilic dermatosis. Hence the discrete pustules in the advancing edge are inflammatory rather than infective. The patient needs oral steroids to