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Arch Dermatol. 2003;139:531-536.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Myelodysplastic syndrome–associated (paraneoplastic) pyoderma gangrenosum (PG).

MICROSCOPIC FINDINGS AND CLINICAL COURSE

Histologic examination of the skin specimen demonstrated a dense neutrophil-rich interstitial infiltrate of the dermis and subcutaneous tissue, without vasculitis. Significant upper dermal edema and extravasated red blood cells were evident within the epidermis and dermis. The infiltrate did not have atypical features. Special stains and cultures were negative for fungal, mycobacterial, and bacterial organisms. A direct immunofluorescence assay was negative for immunoglobulins and complement deposition. Based on the clinical and immunopathologic features, a diagnosis of PG was made.

High-dose intravenous methylprednisolone therapy (750 mg/m²) was initiated and resulted in marked clinical improvement of the PG lesion. Empirical antibiotic therapy was also administered during this period. The patient's lower extremity pain was treated with a patient-controlled analgesic regimen. She was also receiving etoposide and cyclophosphamide for her chronic myelomonocytic leukemia. The ulcer had healed well, with only a few small open areas. One month later, the patient presented with . . . [Full Text of this Article]

DISCUSSION

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Arch Dermatol. 2003;139(4):531-536.
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