A RARE CASE OF PYODERMA GANGRENOSUM WITH COMPLETE SOFT PALATE DESTRUCTION

Abstract

We present the case of a 24 year old male who was admitted to Sf. Maria Clinical Hospital’s Internal Medicine and Rheumatology Department having an impressive soft palate destruction and necrotic ulcers of the posterior oropharynx wall and left palatine tonsil, as well as a gigantic skin ulcer on the left calf. His disease started in 2010, at age 17, with an apfhtous ulceration on his left tonsil and evolved with multiple ulcerations: firstly, in the oral cavity and in time, on skin (face, vermillion, scalp, upper and lower limbs) with bacterial colonisation, and also aseptic arthritis of his both knees. Throughout the past 7 years he was evaluated in many departments and clinics and several diagnoses were raised into question, such as amigdalitis, tonsil tumour, lymphoma, Wegener’s disease, Pyoderma Gangrenosum, PAPA, incomplete SAPHO, Crohn’s disease, Behcet’s disease. Despite the fact that he received multiple therapies, including cDMARDs and bDMARDs, the mucosal and skin lesions had a good response only to corticosteroid treatment and flaired up at the attempt of stoping it.

Keywords

• soft palate destruction
• skin ulcer
• pyoderma gangrenosum