Unveiling the Uncommon: Pyoderma Gangrenosum as an Extraintestinal Complication of Ulcerative Colitis

Pyoderma gangrenosum (PG) is a rare inflammatory skin disorder characterized by neutrophil accumulation, commonly appearing as erythematous papules or pustules that can coalesce into extensive ulcers. It is the second most common dermatologic manifestation of inflammatory bowel disease, though it affects <1% of patients with inflammatory bowel disease. We present a case of a 66-year-old woman with a history of hypothyroidism and hypertension who developed nonhealing abdominal wounds following a small pustule. Despite multiple debridements and antibiotics, her condition worsened, alongside a history of bloody diarrhea for 2.5 years. Investigations led to a diagnosis of ulcerative colitis and PG. The patient was treated with high-dose steroids and infliximab. This case highlights the rarity of abdominal PG as an extraintestinal manifestation of ulcerative colitis and emphasizes the importance of early diagnosis and treatment in improving outcomes for affected patients.