Volume 3, Issue 4, Pages (July 2017)

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Volume 3, Issue 4, Pages 284-287 (July 2017) Nasal septal and mucosal disease associated with pyoderma gangrenosum in a cocaine user Rahul Sehgal, MD, Jeffrey M. Resnick, MD, Ali Al-Hilli, MD, Namrata Mehta, MD, Tyler Conway, MD, Erik J. Stratman, MD JAAD Case Reports Volume 3, Issue 4, Pages 284-287 (July 2017) DOI: 10.1016/j.jdcr.2017.05.004 Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Original 4-cm (L) × 2.2-cm (W) ulcerated plaque, pre-excision (left upper back). JAAD Case Reports 2017 3, 284-287DOI: (10.1016/j.jdcr.2017.05.004) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Skin of back. A, The periphery of the ulcer undermines adjacent skin and is partially re-epithelialized. B, The ulcer bed harbors acute suppurative and plasma cell–rich inflammatory components. The histologic features are consistent with pyoderma gangrenosum. (Hematoxylin-eosin stain.) JAAD Case Reports 2017 3, 284-287DOI: (10.1016/j.jdcr.2017.05.004) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Ulcerating postexcision wound. JAAD Case Reports 2017 3, 284-287DOI: (10.1016/j.jdcr.2017.05.004) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Pretreatment. Nasal mucosal tissue with beefy, friable, slightly erythematous and edematous tissue. JAAD Case Reports 2017 3, 284-287DOI: (10.1016/j.jdcr.2017.05.004) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 5 Naris lesion. A, Acute suppurative folliculitis with rupture and destruction of a follicular infundibulum. B, In the context of the skin of back lesion, the acute suppurative folliculitis at the naris probably denotes an early lesion of pyoderma gangrenosum. (Hematoxylin-eosin stain.) JAAD Case Reports 2017 3, 284-287DOI: (10.1016/j.jdcr.2017.05.004) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 6 A, Progression of ulceration despite treatment. B, Improvement after treatment with prednisone and cyclosporine. JAAD Case Reports 2017 3, 284-287DOI: (10.1016/j.jdcr.2017.05.004) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 7 Improvement in nasal PG lesion after systemic treatment. JAAD Case Reports 2017 3, 284-287DOI: (10.1016/j.jdcr.2017.05.004) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions