Pyoderma gangrenosum - A diagnosis not to be missed

We describe a case of pyoderma gangrenosum VV which presented with severe w ound breakdown after elective hip replacement. The patient was treated succ essfully with minimal wound debridement and steroids. This diagnosis should always be considered when confronted with an enlarging painful skin lesion which does not grow organisms when cultured and fails to respond to antibi otic therapy, especially if there are similar lesions in other sites. In pa tients who have a past history of pyoderma gangrenosum, prophylactic steroi ds may be indicated at the time of surgery or may be required early in the postoperative period.