Pyoderma gangrenosum of the eyelid and acute rhinosinusitis

Pyoderma gangrenosum (PG) is a destructive. necrotizing, noninfective ulcer ation of the skin. Periorbital PG is extremely rare, and may progress, with eventual loss of the eye. We report a 47-year-old woman who presented with a right periorbital swelling of 8 days duration and concurrent acute rhino sinusitis. A clinical diagnosis of right periorbital PG was made, and treat ment instituted with intravenous methylprednisolone and antibiotics, result ing in rapid resolution of the condition. The clinical features in this cas e, together with the past history of histologically confirmed PG, enabled a rapid diagnosis to be made, with early administration of treatment resulti ng in minimal scarring. The clinical picture could easily be confused with periorbital cellulitis. and this case demonstrates the importance of consid ering the differential diagnoses of periorbital swelling.