RT Book, Section A1 Jacks, Stephanie A1 Dean, Steven M. A2 Dean, Steven M. A2 Satiani, Bhagwan A2 Abraham, William T. SR Print(0) ID 1105293006 T1 PYODERMA GANGRENOSUM T2 Color Atlas and Synopsis of Vascular Diseases YR 2015 FD 2015 PB McGraw-Hill Medical PP New York, NY SN 9780071749541 LK accesssurgery.mhmedical.com/content.aspx?aid=1105293006 RD 2024/10/10 AB A 35-year-old woman with no significant medical history presented with a painful ulcer on the right pretibial area. It started as a small pustule that subsequently evolved into a rapidly enlarging ulcer over the course of several weeks. She may have injured the area after falling from her bicycle just prior to the onset of the lesion. A comprehensive review of systems is notable for intermittent crampy abdominal pain and diarrhea for the past year, which had been attributed to irritable bowel syndrome. Laboratory evaluation shows only a mild anemia, but biopsy samples from the terminal ileum are consistent with Crohn disease. A skin biopsy from the edge of the ulcer itself is nondiagnostic. The ulcer improves after initiation of therapy with infliximab for her Crohn disease. Pyoderma gangrenosum is suspected.