PMC4546795_01
Erythematous plaque with vesicular bubbles, elevated edge, interesting the back of the right hand and wrist
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The skin examination found an erythematous plaque of 10 cm of diameter, with a raised border and vesicules, taking the back of the right hand and wrist (Figure 1).
An infiltrated erythematous plaque on the right leg
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There was also an infiltrated erythematous plaque on the right leg (Figure 2) and another topped with a large pustule at the left ankle (Figure 3).
Infiltrated erythematous plaque of the left ankle surmounted by a large pustule
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There was also an infiltrated erythematous plaque on the right leg (Figure 2) and another topped with a large pustule at the left ankle (Figure 3).
Pyoderma gangrenosum: dermal polynuclear suppuration with vasculitis: (HE x 200)
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Skin biopsy showed at the edge of the back of the closet right hand ulcerated epidermis and the dermis infiltrate rich in neutrophils with leukocytoclastic vasculitis finding a PG (Figure 4).
Papillary dermal edema and intense dermal neutrophilic infiltrate with leucocytoclasia without vasculitis
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Other biopsies taken at infiltrated erythematous plaques of the ankle showed a normal appearance of skin, edema of the superficial dermis based on an infiltrate rich in neutrophils without vasculitis confirming the diagnosis of SS (Figure 5).
Early desinfiltration and healing in day 7 of treatment with regression of bubbles
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The evolution was marked since day 7 of treatment by the desinfiltration of the plaques (Figure 6), the recovery of the general condition and disappearance of biological inflammatory syndrome.