Pyoderma gangrenosum associated with sclerosing cholangitis, type 1 diabetes mellitus and ulcerative colitis

We describe the case of a 22-year-old black female with type I diabetes mel litus diagnosed when she was 12 years old. She first presented (March 1994) with pustules and ulcerations on the upper and lower limbs, trunk and scal p at the age 17. The diagnosis of pyoderma. gangrenosum was made. Since pre sentation, changes in liver function were detected and subsequent study led to the diagnosis of sclerosing cholangitis. The diagnosis of ulcerative co litis was made after colonoscopy. Partial response was obtained with minocy cline and clofazimine, but treatment with 5-aminosalicylic acid achieved no improvement of the ulcerations. Liver transplantation, followed by immunos uppressive therapy led to complete regression of the cutaneous lesions.