PYODERMA-GANGRAENOSUM-LIKE ULCERS ASSOCIATED WITH LUPUS ANTICOAGULANT

A 45-year-old woman presented with a deep ulcerative lesion of the lef t breast. Two months later, a new cutaneous necrotic lesion located in the right pretibial area was observed. The only serum abnormality was the presence of circulating lupus anticoagulant. Clinical features su ggested the diagnosis of pyoderma gangraenosum and histologic examinat ion showed microthrombosis in the dermal capillary vessels adjacent to a dense, mixed inflammatory infiltrate with some degree of vascular d amage. Although thrombosis may be the result of vasculitis, it is like ly that in our patient the presence of a lupus anticoagulant activity played a role in the pathogenesis of the cutaneous ulcers.