Rheumatoid arthritis presenting with a non-healing ulcer, diagnosed to be Pyoderma gangrenosum

Abstract

Middle aged male diagnosed with rheumatoid arthritis presented with an acute large painful ulcer spreading over left elbow following an abscess drainage.  Lab values showed normal Procalcitonin ( PCT), high CRP  and sterile wound culture along with skin biopsy . The initial approach included antibiotic management but the ulcer proliferated despite parenteral  antibiotics and regular dressing with a subsequent histopathological diagnosis of pyoderma gangrenosum. Patient improved with steroid and immunosuppressant drug.