Pyoderma Gangrenosum: A Clinical Observation in an Adult Nigerian

Case Definition: Pyoderma gangrenosum (PG) is a destructive, necrotizing non–infective ulceration of the skin of unknown aetiology and rarely reported amongst Nigerians. It is believed to be a reactive inflammatory dermatosis and partly a spectrum of neutrophilic dermatoses. PG usually starts as a painful nodule or pustule that gradually becomes turgid and breaks down to form a progressively enlarging ulcer, with raised tender, undermined violeacous borders. These ulcers may occur singly or in multiples, usually with a prediliction for the lower limbs but may occur elsewhere. It is associated with several medical disorders but can also occur spontaneously in 10-30% of cases.1 PG is a diagnosis of exclusion2. Objective: The atypical presentation of Pyoderma gangrenosum in our patient from a typical hot humid tropical climate where other causes of cutaneous ulceration may simulate or mimic PG and must be excluded was the reason for revisiting this topic. A case of idiopathic pyoderma gangrenosum in a 29 years-old Nigerian male is herein discussed alongside important differentials of tropical cutaneous ulcerations that could mimic it. Keywords: Cutaneous ulceration, Tropics, Nigeria and Pyoderma Gangrenosum Orient Journal of Medicine Vol. 19 (1-4) 2007: pp. 12-1