PYODERMA-GANGRENOSUM SEVERELY AFFECTING BOTH HANDS

We report a case of pyoderma gangrenosum affecting both hands simultan eously. Pyoderma gangrenosum affecting the hands is an extremely rare condition which mag result in considerable tissue destruction. Managem ent includes immunosuppressant therapy, treatment of associated medica l conditions and minimal surgical intervention. Despite a high mainten ance dose of corticosteroid and adequate control of coexisting ulcerat ive colitis and rheumatoid arthritis, tissue destruction in the hands spread rapidly in our patient. The keg to the patient's dramatic impro vement was the tissue biopsy suggesting pyoderma gangrenosum and the s ubsequent treatment with the cytotoxic immunosuppressant, azathioprine .