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Case Reports
. 2025 Jun 4:63:4-7.
doi: 10.1016/j.jdcr.2025.05.008. eCollection 2025 Sep.

High frequency ultrasound for pyoderma gangrenosum: A case series

Katelin R Ross  1 , Shivani Thacker  1 , Mekaila Hudson  1 , Moira Shea  1 , Alex G Ortega-Loayza  1
Affiliations
Case Reports

High frequency ultrasound for pyoderma gangrenosum: A case series

Katelin R Ross et al. JAAD Case Rep. .
No abstract available

Keywords: diagnosis; high frequency ultrasound; imaging; inflammatory conditions; neutrophilic dermatoses; pyoderma gangrenosum; ulcers; wound healing.

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Conflict of interest statement

Dr Ortega-Loayza 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. In addition, he is a consultant for Genentech and Guidepoint and an advisor to Bristol Meyer Squibb, Boehringer Ingelheim, and Janssen. He has received research grants from the Lilly, Janssen, Incyte, and Pfizer. He is supported by National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases R01 AR083110. Authors Ross, Hudson, Shea, and Dr Thacker have no conflicts of interest to declare.

Figures

Fig 1
Fig 1
A, Recurrent PG ulceration on right external ankle. B, HFUS with hypoechoic wound (∗) bulging up through skin; hyperechoic epidermis (∗∗) and hypoechoic dermis (∗∗∗) with abrupt disruption of tissue layers at the ulcer edge (arrow); cobblestoning (interstitial edema) in the subcutaneous layer (∗∗∗∗). C, HFUS microvascular imaging showing highly vascular wound bed with acute vessel angle branching. HFUS, High frequency ultrasound; PG, pyoderma gangrenosum.
Fig 2
Fig 2
A, Healing PG ulceration on left lower extremity. B, HFUS of edge of ulcer. There is a hypoechoic wound bed (∗) with an edematous drainage tract deep to the ulcer (∗∗). At the wound edge, there is normal hyperechoic epidermis, slightly hypoechoic dermis, and subcutaneous layer without evidence of interstitial edema. The thin hyperehcoic epidermis extends from normal tissue at the ulcer edge over the wound bed (arrow). C, HFUS microvascular imaging shows moderate vascularity with organized, linear pattern in wound bed. HFUS, High frequency ultrasound; PG, pyoderma gangrenosum.
Fig 3
Fig 3
A, Basal cell carcinoma (PG-mimicking ulceration) on right lower extremity. B, HFUS demonstrates shallow heterogenous wound bed (∗) and hyperehoic epidermis seen over entire wound with underlying hypoechoic layer (arrow). C, HFUS microvascular imaging with extensive hyperemia in wound bed involving epidermis layer. HFUS, High frequency ultrasound; PG, pyoderma gangrenosum.
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References

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