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For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
Each case should take approximately 2 minutes to complete. There is a list of suggested further reading material at the end of the quiz.
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What is the name for the skin condition?
Pyoderma gangrenosum
What medications may be responsible?
Hydroxyurea contributed to slow healing
What management would you recommend?
The lower leg ulceration in this patient was diagnosed as pyoderma gangrenosum in association with myelodysplasia. It was extremely painful and failed to improve with systemic steroids and other therapies. The patient was on hydroxyurea, which is well known to cause leg ulceration, possibly related to microtrauma in anoxic, atrophic skin. When the hydroxyurea was discontinued, the ulcer steadily healed. Leg ulcers are sometimes also due to vasculitis, which also may be drug-induced.