CEPHALIC PYODERMA-GANGRENOSUM (PG)-LIKE LESIONS AS A PRESENTING SIGN OF WEGENERS GRANULOMATOSIS

Background. Pyoderma gangrenosum (PG)-like lesions can be associated w ith Wegener's granulomatosis (WG); in rare instances, they could be th e presenting sign of WG. The purpose of this study was to elucidate th e relationship between these two disorders. Methods. The clinical and histologic data from a case of WG with primary ulcerative lesions of t he face were compared with five other cases previously reported in the literature. Results. A predominance among young men was noted. in thr ee patients the histology of the skin ulcerations was suggestive of WG , in the remaining three, including the case described, it was nonspec ific. Two cases developed pulmonary WG after the skin lesions cleared, showing that the extent and severity of skin lesions do not necessari ly correlate with the systemic disease. Conclusions. When the histolog y of the skin is nonspecific, the diagnosis of PG or PG-like lesions o f the head and neck should not be considered definitive and the patien ts should be carefully monitored to rule out the possible presence of WG.