ePlasty: Vol. 16
Severe Bilateral Lower Extremity Pyoderma Gangrenosum
Jake Laun, MDa, Joshua B. Elston, MDa, Michael A. Harrington, MD,a and Wyatt G. Payne, MDb

aDivision of Plastic Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, Tampa; and bC.W. Bill Young Bay Pines VA Medical Center, Bay Pines, Fla

Correspondence: jelston1@health.usf.edu
Keywords: pyoderma gangrenosum, pathergy, wound, lower extremities, TNF-α inhibitors
Figure 1. Severe bilateral lower extremity wounds that had progressed over months despite aggressive wound care and medical management with immunomodulators and steroids.
Figure 2. After conservative debridement of all necrotic material on the bilateral lower extremities. Multiple tendons are noted in the bilateral lateral compartments of the legs, with beefy-appearing proud tissue noted at the wound margins.
Figure 3. Straight down view demonstrating involvement of bilateral lower extremities with exposed tendons.