A 29-year-old woman presented to the Greater Manchester Dermatology Center, Manchester, England, with a 12-year history of cutaneous ulcerations that required admission to the hospital on several occasions. At the time of presentation, she was living alone with her father, and concerns were expressed regarding possible neglect. Four years prior to presentation, she was admitted to an intensive care unit with sepsis. Full-thickness skin loss over the chest, back, and buttocks was noted, as was poor personal hygiene, suggesting self-neglect; the skin lesions were attributed to self-harm. Despite regular dressing changes, the ulcerations failed to heal, and new areas developed under the occlusive dressings. Prior to referral to our center, she was being considered for bilateral mastectomy in an attempt to control the severe ulcerations over her breasts.
Harries MJ, McMullen E, Griffiths CEM. Pyoderma Gangrenosum Masquerading as Dermatitis Artefacta. Arch Dermatol. 2006;142(11):1508-1518. doi:10.1001/archderm.142.11.1509-b