A Curious Case of Cutaneous Pathergy: Pyoderma Gangrenosum in the Setting of Hepatitis C and Cocaine Use

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis that presents with rapidly developing, painful ulcers, often associated with underlying autoimmune or hematological conditions. Pathergy, the exacerbation of skin lesions after minor trauma, is a hallmark of PG but may be present in other diseases. Hepatitis C virus (HCV) infection and cocaine use have been increasingly recognized as potential triggers of PG and pathergy. This case describes a patient with hepatitis C and active cocaine usage, without any known systemic inflammatory conditions, who developed pathergy and met the 2018 Delphi Criteria for PG.