Pyoderma gangrenosum as a possible paraneoplastic disease - case study and literature review

Abstract

Introduction: Pyoderma gangrenosum is a rare dermatosis characterised by a rapid course and uncertain prognosis. It poses a major therautic challenge in the daily dermatological practice, also to experienced medical practitioners. Pyoderma gangrenosum may coexist with autoimmune diseases, but it can also a paraneoplatic diseease associated with cancers of internal organs and myeloproliferative diseases. Case report: We present a 78-year-old woman with pyoderma gangrenosum hospitalised in the Clinical Department of Dermatology and to review the literature on the coexistence of pyoderma gangrenosum and neoplastic deseases of internal organ cancers. In our patient pyoderma gangrenosum was associated with duodenal thickening observed on computer tomography combined with a positive test for occult blood in the stool. It led to the suspicion of gastrointestinal malignancy. However the patient refused further diagnostic procedures. Conclusions: Multiple case studies and review articles point to a statistically significantly increased frequency of neoplatic diseases (both hematologic malignanciues and solid tumours) in patients with pyoderma Thus, a reasonable strategy is to perform cancer screening in patients with pyoderma gangrenosum. Not all patients consent to expand the diagnostic procedures to confirm or exclude the suspicion of a neoplastic disease.