2026-07-01 | Peristomal Pyoderma Gangrenosum Related to Systemic Lupus Erythematosus: A Case Study.
Peristomal pyoderma gangrenosum (PPG) is a rare complication of peristomal skin. It is difficult to manage, and there are no guidelines for treatment. This case study describes the management of a patient with PPG while taking corticosteroids and cyclosporine as chronic therapy for systemic lupus erythematosus (SLE). Mrs. T had SLE and a colostomy and developed PPG that was unresponsive to previous treatment. She was successfully treated with a barrier film, a topical corticosteroid, and an alginate dressing. The synergistic use of a barrier film, a topical corticosteroid, and an alginate proved to be effective for the management of PPG lesions in SLE.
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2026-06-30 | [A CASE OF PENILE PYODERMA GANGRENOSUM WITH STERILE ABSCESS SUCCESSFULLY TREATED WITH CORTICOSTEROIDS].
Pyoderma gangrenosum is a non-bacterial inflammatory disease that forms ulcers and abscesses and can be exacerbated by mechanical stimulation. Surgical intervention for abscesses in the corpora cavernosa may exacerbate penile pyoderma gangrenosum. We report a case of penile pyoderma gangrenosum that was diagnosed minimally invasively by biopsy alone and treated with steroids. A 77-year-old man with penile swelling and pain was referred to our institution by his primary care physician for suspected penile cancer. Both infectious diseases and penile cancer were ruled out based on physical examination and laboratory test results. Magnetic resonance imaging revealed fluid accumulation in the corpora cavernosa, leading to the decision to perform a penile biopsy. The biopsy revealed no malignancy, but an abscess was identified. Based on the clinical presentation, penile pyoderma gangrenosum was suspected and steroid therapy was initiated, resulting in rapid symptomatic improvement. The steroid dose was gradually tapered, and after 18 months of treatment, the steroids were discontinued. The patient has remained asymptomatic with no recurrence of the abscess or other subjective complaints.
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2026-06-29 | Pyoderma Gangrenosum Following Cesarean Section: A Case Report With Individualized Management.
Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly progressive necrotizing skin ulcers. PG following cesarean section (CS) is extremely rare and frequently misdiagnosed as surgical site infection, leading to inappropriate debridement and disease exacerbation. We report a case of severe postcesarean PG successfully managed with early immunosuppressive therapy. A 24-year-old primiparous woman at 29 + 4 weeks gestation underwent emergency CS due to umbilical cord prolapse. On postoperative day (POD) 7, she developed painful ulcers with undermined violaceous borders around the incision. Despite broad-spectrum antibiotics, lesions progressed rapidly. Pathergy occurred following surgical debridement on POD 9 (wound enlarged to 21.5 × 11.0 cm). PG was diagnosed on POD 11 based on clinical features, sterile cultures, and neutrophilic infiltrate on histopathology. Treatment included methylprednisolone pulse therapy (500 mg intravenously daily for 3 days), followed by tapering to 60 mg/day with concurrent initiation of cyclosporine (75 mg oral twice daily) and etanercept (25 mg subcutaneously twice weekly). The patient was discharged on POD 30. Complete epithelialization was achieved by the 4th postoperative month without recurrence or adverse drug reactions. This case highlights the diagnostic challenges of postcesarean PG, which requires high clinical suspicion to distinguish from infectious complications. Triple immunosuppressive therapy (high-dose corticosteroids, calcineurin inhibitor, and TNF-α antagonist) represents an effective strategy for severe, rapidly progressive disease, allowing rapid disease control while facilitating corticosteroid tapering. Long-term follow-up confirmed sustained remission despite extensive initial ulceration.
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