Pyoderma gangrenosum is an uncommon ulcerative skin disorder that occu
rs in all age groups. Approximately 4% of patients are infants and chi
ldren. There are several notable differences between the childhood and
adult manifestations of the disease, including the distribution of le
sions and associated disorders. We reviewed the childhood cases (less-
than-or-equal-to 18 yrs of age) of unequivocal pyoderma gangrenosum in
the English literature and tabulated the trends in clinical features,
associated disorders, and therapy. We report our 3-week-old patient,
the youngest documented case. Of the 46 patients, only 4 were less tha
n 1 year of age. A systemic illness was present in 74% of the older ch
ildren, most commonly, ulcerative colitis. Only one infant had an asso
ciated problem (HIV+) at the time of onset. Infants appear to have an
unusual distribution of perianal and genital lesions not often describ
ed in other age groups. Our review suggests that pyoderma gangrenosum
in children has a similar clinical appearance to that in adults. It is
associated with some of the same underlying disorders, but with diffe
rent frequencies. The distribution of lesions in children is similar,
often involving the lower extremities, but pyoderma gangrenosum of the
head and face appears to be more common in children. Infants may have
ulcers in genital and perianal areas. The most frequently prescribed
treatment for children is systemic corticosteroids, which generally ar
e very effective.