Extracutaneous Manifestation of Ulcerative Colitis: Pyoderma Gangrenosum, A Case Report

Pyoderma gangrenosum (PG) is a rare, ulcerative skin condition often associated with systemic diseases such as inflammatory bowel disease (IBD), including ulcerative colitis (UC). This case report describes a 79-year-old male patient with a history of ulcerative colitis who presented with increased passages of blood-mixed stools and a solitary ulcer on the left lower shin following minor trauma. The ulcer, measuring 10 cm by 4 cm, exhibited a violaceous border with purulent necrotic tissue. Histopathological examination revealed neutrophilic exudate, dense inflammatory cell infiltrate, perivascular neutrophilic infiltration, extravasated red blood cells, congested blood vessels, and hemosiderin-laden macrophages. The clinical presentation, along with the biopsy findings, confirmed the diagnosis of PG associated with UC. The patient was managed with systemic corticosteroids and antineutrophilic therapy, emphasizing the importance of early diagnosis and treatment to prevent disease progression. This case underscores the need for vigilance in identifying PG in patients with IBD, as prompt intervention can significantly improve outcomes.