Skin Lesion | Figure 1
ReginaldoCastro
Specialty: Internal Medicine
Skin Lesion
Patient Profile: 10 years old, male, previously healthy.
He’s with a progressive extensive skin lesion on the right lower limb evolving over approximately 3 weeks.
The condition started as small erythematous papules, which rapidly progressed to painful erosive and ulcerated plaques, with exudation, crust formation and irregular borders.
What is the probable diagnosis?
Update 1
The most likely diagnosis is PYODERMA GANGRENOUS.
Findings that support this hypothesis:
- Start as erythematous papules with rapid progression to painful ulcers
- Fast evolution (weeks)
- Irregular and inflammatory edges, with exudate and crusts
- Lower limb location (classic site)
- Pain disproportionate to the initial aspect of the injury
Differential diagnoses:
- Ectima gangrenous (especially if there is immunosuppression or sepsis)
- Ulcerated cutaneous leishmaniasis
- Impetigo ectimatous
- Ulcerated cutaneous vasculitis
- Localized necrotizing bacterial infection
- Complicated arthropod sting
Diagnosis Added
Diagnosed As: Pyoderma Gangrenous