Pyoderma gangrenosum was diagnosed in two patients with pulmonary sarcoidosis who were being treated with low doses of oral prednisone. These cases illustrate the tendency of pyoderma gangrenosum to develop in patients with defective immune reactivity and in those being treated with immunosuppressive agents.
Report of Cases
Case 1.—
A 50-year-old man was seen in July 1981, because of a nine-month history of multiple ulcerating skin lesions that had not responded to local therapy, orally administered antibiotics, or skin grafting. He had a 15-year history of pulmonary sarcoidosis diagnosed by open-lung biopsy and treated with prednisone. He was taking 15 mg/day of prednisone when the cutaneous lesions developed. Examination disclosed 20 to 30 deep tender ulcers on the legs, arms, and abdomen. The ulcers were 1 to 10 cm in