Mucosal Pyoderma Gangrenosum

A 72-year-old man consulted us because of recurrent ulcerations on the right palatal arch over the past ten years. A lesion of this type had once been excised and found to be benign. Multiple subsequent recurrences regressed under treatment with a steroid taper each time. Our examination revealed extensive ulceration of the right palatal arch (Figure). Biopsy yielded a finding of ulcerative, neutrophil-rich mucositis. A comprehensive search for responsible pathogens and antibodies was negative. There was no evidence of chronic inflammatory bowel disease, rheumatoid arthritis, or any underlying hematologic disease. We diagnosed mucosal pyoderma gangrenosum and initiated short-term treatment with cyclophosphamide. This led to short-term improvement, but the patient died a few weeks later of fulminant sepsis. Pyoderma gangrenosum is an inflammatory, ulcerating skin disease. Purely mucosal manifestations of pyoderma gangrenosum are exceedingly rare.

Figure

Mucosal Pyoderma Gangrenosum

Dr. med. Aleksander Markovic, Prof. Dr. med. Jan Christoph Simon, Prof. Dr. med. Manfred Kunz, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, [e-mail]

Conflict of interest statement: The authors state that they have no conflict of interest.

Translated from the original German by Ethan Taub, M.D.

Cite this as: Markovic A, Simon JC, Kunz M: Mucosal pyoderma gangrenosum. Dtsch Arztebl Int 2020; 117: 614a. DOI: 10.3238/arztebl.2020.0614a