Pyoderma Gangrenosum Involving all Four Extremities.

Pyoderma gangrenosum (PG) is a rare inflammatory ulcerative condition that occurs in less than 10 cases per million people per year. Diagnosing this condition is difficult as there are no definitive serological or histopathological markers, and it is considered a clinical diagnosis of exclusion. The authors present a unique case of PG involving all 4 extremities--a distribution not previously reported. This case highlights the importance of a comprehensive and systematic workup of these patients; early recognition of PG, which can have unusual presentations; and a cautious approach to surgical debridement.