Experience in early diagnosis of pyoderma gangrenosum: A case report

The early clinical manifestations of pyoderma gangrenosum are not characteristic, it resembles other infectious skin lesions and is difficult to identify in the early stages. The exploratory surgery for direct observation of the superficial fascia of the suspected infection site for signs of infection, together with the collection of tissue samples for bacterial culture, combined with histopathological biopsy and clinical manifestations, was of significant value in the differential diagnosis of this disease and infectious skin lesions with similar manifestations. We introduce a patient who was admitted to hospital with redness and swelling of the left calf and foot for 7 days. The local appearance of the lesion resembled a carbuncle or early-stage necrotizing fasciitis. We performed surgical exploration for a definitive diagnosis but found no signs of infection, therefore, infection could be preliminarily ruled out. The disease was finally diagnosed as pyoderma gangrenosum, which was treated with hormone therapy and recovered after dressing change.