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Case Reports
. 2013 Jun 30;7(2):64-8.
doi: 10.3315/jdcr.2013.1140. Print 2013 Jun 30.

Pyoderma gangrenosum of the breast treated with intravenous immunoglobulin

Sudipta Sinnya  1 , Saud Hamza
Affiliations
Case Reports

Pyoderma gangrenosum of the breast treated with intravenous immunoglobulin

Sudipta Sinnya et al. J Dermatol Case Rep. .

Abstract

Background: Pyoderma gangrenosum is a rare neutrophilic dermatosis which leads to necrotic and painful skin ulceration. PG of the breast is extremely rare with 32 documented cases in the current literature. Delay in diagnosis worsens scarring as the ulcers are rapidly expanding, painful and usually slow to heal.

Case presentation: We present a case of pyoderma gangrenosum of the breast in a patient with associated rheumatoid arthritis which was initially diagnosed as an infected breast ulcer and later successfully treated with systemic steroids and intravenous immunoglobulin (IVIG).

Conclusion: Even though PG of the breast has been gaining increased recognition over the past two decades, this has been more common in the post-surgical setting. This case highlights the need to consider PG as a differential diagnosis when faced with unsual cases of breast ulceration and the importance of multidisplinary approach for effective treatment of this condition.

Keywords: breast; intreavenous immunoglobulins; mycobacterium ulcerans; pyoderma gangrenosum; rheumatoid arthritis; ulcer.

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Figures

Figure 1
Figure 1
Extensive painful ulcer on right breast at initial presentation.
Figure 2
Figure 2
Histopathology showing ulceration and abundant neutrophils (Magnification x200 high power field).
Figure 3
Figure 3
Massive reduction in the size of the ulcer 6 weeks post IVIG therapy.
Figure 4
Figure 4
Near complete resolution of the ulcer with scarring.
See this image and copyright information in PMC

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