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Review
. 2025 Jul;26(4):511-523.
doi: 10.1007/s40257-025-00941-z. Epub 2025 Mar 28.

Clinical Mimickers Misdiagnosed as Pyoderma Gangrenosum

Sarah L Becker  1 , Ahmed H Badawi  2   3 , Chase Thornton  4 , Alex G Ortega-Loayza  5
Affiliations
Review

Clinical Mimickers Misdiagnosed as Pyoderma Gangrenosum

Sarah L Becker et al. Am J Clin Dermatol. 2025 Jul.

Abstract

Pyoderma gangrenosum (PG) is a rare, ulcerative, neutrophilic dermatosis that can be challenging to diagnose. Diagnosis of PG is clinical due to a lack of specific histopathologic, immunologic, or imaging findings associated with the disease, although several clinical frameworks exist to guide diagnosis. However, misdiagnosis of PG is frequent and leads to increased patient morbidity and mortality. This article highlights common mimickers of PG and offers clinical pearls to aid in accurate diagnosis with the goal of decreasing diagnostic delay and misdiagnosis and improving patient outcomes.

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Conflict of interest statement

Declarations. Competing interests: A.G.O.L. is the former President of the Pacific Dermatology Association and serves as an associate editor for Dermatology (Karger) and editorial board member of the American Journal of Clinical Dermatology. A.G.O.L. was not involved in the selection of peer reviewers for the manuscript nor any of the subsequent editorial decisions. Additionally, he is a consultant for Genentec, Guidepoint, InflaRx, Corvus pharmaceuticals, Castle Biosciences, Clarivate, TFS HealthScience, Otsuka, and Leo Pharma. He is an advisor to Bristol-Meyers Squibb, Boehringer Ingelheim, Janssen, and Sanofi. Dr. Ortega has received research grants from Lilly, Janssen, Incyte and Pfizer. He is supported by National Institutes of Health (NIH) National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) R01 AR083110. A.H.B. served on the advisory board for Boehringer Ingelheim and Blueprint Medicines for unrelated disease states. Authors S.L.B. and C.T. have no conflicts to disclose. Funding: No funding was received for this project. Availability of data and material: No data were generated in the creation of this manuscript. Consent to publish: Patients signed informed consent regarding publishing their data and photographs. Ethics approval: Not applicable. Patient consent to participate: Not applicable. Code availability: Not applicable. Author contributions: Original text—S.L.B. Critical revisions—A.G.O.L., C.T., and A.H.B. All authors read and approved the final version.

References

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