Differential diagnosis of ulcerative lesions in a patient with pyoderma gangrenosum in association with ulcerative colitis and multiple endocrine neoplasia

Differential diagnosis of chronic ulcers of non-infectious nature remains a complex interdisciplinary problem. Pyoderma gangrenosum is a rare autoinflammatory disease, which is referred to the group of neutrophilic dermatoses and is clinically manifested by the rapid development of painful, long-term persistent, recurrent skin ulcers with irregular, undermined borders of red-violet colour and surrounding erythema. Annually from 3 to 10 cases of pyoderma gangrenosum per million people are reported. To the present time, the etiology and pathogenesis of pyoderma gangrenosum remain completely unstudied, and the diagnosis is complicated by the rare incidence of the disease and non-specificity of cutaneous manifestations. In this article the observation of a long-term course of pyoderma gangrenosum in a 58-year-old female with ulcerative colitis and multiple endocrine neoplasia type I. The differential diagnosis between pyoderma gangrenosum with necrotising ulcerative vasculitis was performed. Based on the results of the comprehensive examination, the final diagnosis of pyoderma gangrenosum was established. This clinical observation demonstrates the necessity for the detailed examination of patients in order to make a correct diagnosis and prescribe adequate treatment on time.