Necrotizing Dermatosis of the Arm Following Cubital Tunnel Release: Pyoderma Gangrenosum, the Great Mimic by Alfonso Utrillas-Compaired, Richard Paul Jeavons,

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Necrotizing Dermatosis of the Arm Following Cubital Tunnel Release: Pyoderma Gangrenosum, the Great Mimic by Alfonso Utrillas-Compaired, Richard Paul Jeavons, Ramón Viana-López, and Ignacio González-Gómez JBJS Case Connect Volume 5(2):e55 June 24, 2015 ©2015 by The Journal of Bone and Joint Surgery, Inc.

The development of erythematous-to-violaceous papules, nodules, and vesiculobullous lesions at sites of dermal trauma, as well as extension of the lesion where debridement has occurred, are all signs of disease progression and potential clues to the diagnos... Alfonso Utrillas-Compaired et al. JBJS Case Connect 2015;5:e55 ©2015 by The Journal of Bone and Joint Surgery, Inc.

A photograph depicting the typical course of postsurgical PG. During the early postoperative period, fever, chills, cellulitis, and breakdown of the wound dominate the clinical picture. Alfonso Utrillas-Compaired et al. JBJS Case Connect 2015;5:e55 ©2015 by The Journal of Bone and Joint Surgery, Inc.

The hallmark finding is a rapidly enlarging area of central skin ulceration surrounded by a rim of violaceous skin with irregular borders. Alfonso Utrillas-Compaired et al. JBJS Case Connect 2015;5:e55 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Despite prolonged use of IV antibiotics, antifungal treatment, and serial operative debridements, the clinical picture remained unchanged, with the wound edges continuing to necrose after each procedure. Alfonso Utrillas-Compaired et al. JBJS Case Connect 2015;5:e55 ©2015 by The Journal of Bone and Joint Surgery, Inc.

A remarkable clinical improvement was seen almost immediately after immunosuppressive therapy with systemic corticosteroids. Alfonso Utrillas-Compaired et al. JBJS Case Connect 2015;5:e55 ©2015 by The Journal of Bone and Joint Surgery, Inc.

The limb, two years after treatment, epithelialized without skin grafting. Alfonso Utrillas-Compaired et al. JBJS Case Connect 2015;5:e55 ©2015 by The Journal of Bone and Joint Surgery, Inc.