Pyoderma Gangrenosum with an Unusual Syndrome of Ulcers, Vesicles, and Arthritis

Cases presenting unusual chronic and recurring ulcerations of unknown or debatable etiology have been reported over a period of years in both dermatological and surgical literature. The cases vary considerably as regards acuteness or chronicity; size, depth, and multiplicity of lesions, and other accompanying or complicating symptoms. Possibly several different entities are represented in the reported cases, although the Meleneytype ulcer, 1 containing a symbiotic growth of microaerophilic streptococci and staphylococci, and the cases described by Brunsting, Goeckerman, and O'Leary in 1930 2 as pyoderma gangrenosum may be variants of the same entity. These authors reviewed the extensive literature on obscure ulcerative and gangrenous lesions and reported five cases of an entity which appeared to represent a syndrome consisting of unusual recurring cutaneous ulcers associated with a chronic debilitating systemic infection. In four of the five cases, the underlying condition was ulcerative