PYODERMA GANGRENOSUM AND CHRONIC ACTIVE HEPATITIS: A CASE REPORT

Abstract

A 30-year-old woman with a complex 13-year history of chronic active hepatitis developed pyoderma gangrenosum whilst on treatment with low dose prednisone and azathioprine. A histological picture of suppurative granulomatous inflammation on skin biopsy raised the possibility of an opportunistic infection and delayed the diagnosis and institution of appropriate therapy. The lesions failed to heal with skin grafting or clofazimine therapy. Increased doses of azathioprine had to be ceased because of toxicity. High dose corticosteroids induced healing although vertebral osteoporosis necessitated its rapid withdrawal.