Multiple choice: lower extremity ulcer

Authors

  • María Belén Godoy Pte. Dr. Nicolás Avellaneda Hospital of Clinics, San Miguel de Tucumán, Tucumán
  • Fabiana Paola del Valle Argañaraz Pte. Nicolás Avellaneda Hospital of Clinics, San Miguel de Tucumán, Tucumán
  • María de la Paz Gonella del Carril Pte. Nicolás Avellaneda Hospital of Clinics, San Miguel de Tucumán, Tucumán

Keywords:

lower extremity, ulcer

Abstract

A 36-year-old male patient, from Tafí Viejo, Tucumán province, with a history of hospitalization in 2019 due to polyneuropathy and oligoarthritis of more than 6 years of evolution, without a definitive diagnosis. He was admitted on call in poor general condition, with skin-mucous pallor, generalized edema, oligoanuria, walking disorders, hypotension, and hyperglycemia. During hospitalization, after 20 days, he developed an ulcer 10 cm in diameter, located on the anterolateral aspect of the left leg, with a defined, raised edge, with a purpuric peripheral halo and a necrotic background, cold to the touch and painful to the touch. palpation. At the perianal level, he presented an ischiorectal abscess. A biopsy of the ulcer was performed for histopathological and laboratory study with a complete rheumatological profile. Pancytopenia, renal failure, hypernatremia, negative serologies and positive anticitrullinated peptide (anti-CCP) antibody were evidenced. He was admitted to the operating room for drainage of the ischiorectal abscess. After 3 days, he died due to multiple organ failure.

Author Biographies

María Belén Godoy, Pte. Dr. Nicolás Avellaneda Hospital of Clinics, San Miguel de Tucumán, Tucumán

Dermatology Residency

Fabiana Paola del Valle Argañaraz, Pte. Nicolás Avellaneda Hospital of Clinics, San Miguel de Tucumán, Tucumán

Dermatology Residency

María de la Paz Gonella del Carril, Pte. Nicolás Avellaneda Hospital of Clinics, San Miguel de Tucumán, Tucumán

Dermatology Residency

References

I. Martín Pozo Y, Pérez Fleites D, Betancourt Pérez A. Pioderma gangrenoso. Informe de caso. Acta Médica del Centro 2021;15:612-617.

II. Pizzariello G, Olivares L, Lois M, Anaya J, et ál. Pioderma gangrenoso vegetante. Presentación de 7 casos. Dermatol Argent 2012;18:383-388.

III. Rico Sánchez-Mateos E, Abbasi Pérez A, Suárez Cuba J, Montaño Tapia L. Protocolo diagnóstico y tratamiento del pioderma gangrenoso. Medicine 2021;13:1861-1864.

IV. Trejo-Acuña JR, Medina-Bojórquez A, Ramos-Garibay JA, Zárate-Flores LM, et ál. Pioderma gangrenoso asociado a artritis reumatoide. Rev Cent Dermatol Pascua 2021;30:148-155.

Published

2022-09-01

Issue

Section

Young Dermatologists