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- Skin ulceration - classically on the legs.
- Early: lymphocytes cells only in the dermis - often perivascular & vascular.
- +/-Fibrinoid necrosis of vessels at edge of lesion.
- Late: abscess formation (neutrophils).
A. Skin, Left Leg from Central Wound, Punch Biopsy: - Necrotic debris with underlying granulation tissue and benign connective tissue with superficial vasculitis, see comment. - NEGATIVE for skin surface. B. Skin, Left Leg from Wound and Normal Skin Junction, Punch Biopsy: - Skin with ulceration, necrotic debris, and superficial vasculitis, see comment. - Fat necrosis and severe atherosclerosis. Comment: The findings are in keeping with pyoderma gangrenosum; however, atherosclerotic disease and vasculitis should be considered clinically. The vasculitis is seen superficially and is likely secondary to the ulceration.
Skin, Left Lower Leg, Punch Biopsy: - Skin with ulceration, necrotic debris, superficial vasculitis, subepidermal fibrosis and maturing granulation tissue, see comment. - NEGATIVE for evidence of malignancy. Comment: The findings are in keeping with pyoderma gangrenosum; however, vasculitis and atherosclerosis should be considered clinically. The vasculitis is seen superficially and is favoured to be secondary to the ulceration.
- Brooklyn, T.; Dunnill, G.; Probert, C. (Jul 2006). "Diagnosis and treatment of pyoderma gangrenosum.". BMJ 333 (7560): 181-4. doi:10.1136/bmj.333.7560.181. PMC 1513476. PMID 16858047. //www.ncbi.nlm.nih.gov/pmc/articles/PMC1513476/.
- Wong, WW.; Machado, GR.; Hill, ME.. "Pyoderma gangrenosum: the great pretender and a challenging diagnosis.". J Cutan Med Surg 15 (6): 322-8. PMID 22202507.