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April 2016

Misdiagnosed Periocular Pyoderma Gangrenosum Requiring Ectropion Repair With Development of Second Lesion of Pyoderma Gangrenosum at Graft Site

Author Affiliations
  • 1Division of Dermatology, University of Louisville, Louisville, Kentucky
  • 2Associate Editor, JAMA Dermatology
JAMA Dermatol. 2016;152(4):491-492. doi:10.1001/jamadermatol.2016.0062

Pyoderma gangrenosum (PG) is a rare ulcerating inflammatory skin disease diagnosed after exclusion of infection, neoplasia, thrombophilia, and other inflammatory conditions. The incidence is between 3 to 10 patients per million and affects slightly more women than men in the second through fifth decades of life.1 The pathogenesis of PG is multifactorial and involves neutrophilic dysfunction, inflammatory mediators, and a genetic predisposition. Considering the diagnosis of PG for nonhealing ulcers that show a predominance of neutrophils on pathologic analysis is important to prevent unnecessary morbidity.

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