Refractory pyoderma gangrenous and Thalidomide

Abstract

Pyoderma gangrenosum is a neutrophilic dermatosis that presents six clinical variants. We report the case of a 31-year-old woman, who presents with the classic or ulcerative form of pyoderma gangrenosum characterized by three ulcers with purulent secretion, with irregular, violaceous, undermined, painful edges, with a torpid evolution, with positive pathergy, without initial response. to systemic corticosteroids. Skin biopsy shows neutrophilic infiltrate,
without vasculitis. It was not associated with underlying comorbidities. Dramatic response with thalidomide. The healing left a cribriform scar. The objective is to review the clinical picture, diagnostic criteria and therapeutic approach of this rare entity. We conclude that the diagnosis of pyoderma gangrenosum is complex and in refractory
cases there is a good response with thalidomide.