Pathergy Phenomenom: Indicator of Recurrent Vegetative Pyoderma Gangrenosum

¹Department of Dermatology and Venerology, Dominican Dermatology Institute “Dr. Huberto Bogaert Diaz”, Dominican Republic

²Department of Pathology, Dominican Dermatology Institute “Dr. Huberto Bogaert Diaz”, Dominican Republic

*Corresponding Author: Dra. Mariel Amelia Isa Pimentel, Dominican Dermatology Institute “Dr. Huberto Bogaert Diaz”; Albert Thomas Ave #66, Santo Domingo 10306, Dominican Republic; Tel: +1 (809) 707-1245; Email: [email protected]

Received Date: February 28, 2024

Publication Date: March 30, 2024

Citation: Isa M, et al. (2024). Pathergy Phenomenom: Indicator of Recurrent Vegetative Pyoderma Gangrenosum. Dermis. 4(1):11.

Copyright: Isa M, et al. © (2024).

ABSTRACT

Background: Pyoderma gangrenosum vegetans is an uncommon subtype of pyoderma gangrenosum of unknown etiology. It manifests as a solitary superficial vegetative ulcer, usually on the head, neck, and trunk of gradual onset with good response to treatment with immunomodulators. Case report: A 65-year-old female patient, hypertensive, with a painful erythematous plaque of 2.5cm in diameter, with raised edges and a slightly depressed center with the presence of purulent collection on the dorsum of the right hand of 3 days of evolution. Skin biopsy showed dense and diffuse neutrophil infiltrates in dermis. The lesion showed spontaneous remission without treatment. One year later the patient presented a painful exulcerated erythematous plaque, with vegetative edges, with the presence of a serohematic crust on its surface, 10cm in diameter, with 15 days of evolution, on the same extremity. Patient reports similar injuries in the past that appear after being traumatized by rose thorns in her garden. Skin biopsy shows neutrophilic infiltrate. Topical steroid treatment was initiated with complete resolution of the lesion. Conclusion: Pyoderma gangrenosum vegetans is not associated with systemic diseases, showing a favorable prognosis. This patient meets the necessary criteria to make the diagnosis, presenting neutrophilic infiltrate in the biopsy, decrease in the lesion after treatment with steroids, Pathergy phenomenon, as well as absence of infection demonstrated by negative cultures (3).

Keywords: Pyoderma gangrenosum vegetans, Pathergy phenomenon, neutrophilic dermatosis