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Pathergy phenomenon leading to the diagnosis of pyoderma gangrenosum

Pyoderma gangrenosum (PG) is a rare skin disease of chronic course and a tendency for recurrence. Pathergy phenomenon, which is characterized by the rapid development of skin lesions at the site of a mechanical trauma, affects about 30% of patients with PG. However, this symptom is not pathognomonic for PG and may develop in other conditions including Behcet’s disease, Sweet syndrome and Crohn’s disease. In the current paper, we present a 25-year-old woman with an infiltrative lesion with a tendency for ulceration located in the interscapular region. Excision of the skin lesion led to the development of infiltration with small ulcerations at the site of surgical intervention. Clinical presentation corresponded to the classical pathergic reaction, which in turn raised the suspicion of PG. Therapy consisted of cyclosporin 5 mg/kg/day and topical ointment with 0.05% of betamethasone and 0.1% of gentamicin. Complete healing was observed after three weeks of treatment. We present the case in order to draw attention to the diagnostic significance of pathergy phenomenon in dermatology.