Description

Weenig et al listed a number of conditions that may mimic pyoderma gangrenosum (PG). Failure to consider these in the differential diagnosis can result in misdiagnosis. The authors are from the Mayo Clinic in Rochester.


 

Conditions (other than PG) that can cause cutaneous ulcers include:

(1) vasculitis

(2) vascular occlusions

(3) skin involvement in hematologic malignancies

(4) skin infection

(5) drug-induced skin ulcers

(6) toxin-induced skin ulcers

(7) other

 

Causes of vasculitis:

(1) Wegener's granulomatosis

(2) polyarteritis nodosa (PAN)

(3) cryoglobulinemia (as vasculitis or occlusive)

(4) Takayasu's vascultiis

(5) leukocytoclastic vasculitis

(6) drug-induced lupus

 

Conditions with vascular occlusions:

(1) antiphospholipid antibody

(2) livedoid vasculopathy

(3) venous stasis ulceration

(4) small vessel occlusive arterial disease

(5) Klippel-Trenaunay-Weber syndrome

 

Hematologic malignancies:

(1) T cell lymphoma (angiocentric, anaplastic large cell, Mycosis fungoides)

(2) leukemia cutis

(3) Langerhans cell histiocytosis

 

Skin infection:

(1) fungal infection

(2) herpes simplex virus

(3) mycobacterial infection

(4) amebiasis cutis

(5) Pseudomonas aeruginosa or other Gram negative bacteremia

 

Drug-induced skin ulcers:

(1) hydroxyurea

 

Toxin-induced skin ulcers:

(1) bromoderma

(2) spider bites (brown recluse spider)

 

Miscellaneous:

(1) ulcerating necrobiosis lipoidica

(2) cutaneous Crohn's disease

(3) Munchausen's syndrome or other factitious disorder

(4) injection site reaction

(5) contact vulvitis

 


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