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Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by noninfectious ulcers, usually involving the lower extremities, with an estimated incidence rate of 3–10 cases per million per year [1]. PG is associated with underlying systemic diseases in around 50% of cases [2]. Modified immunological response and altered neutrophilic chemotaxis have been proposed as the underlying mechanism of pathogenesis. Pathergy is seen in one-fourth of cases of PG [3]. Herein, we report a case of giant pyoderma gangrenosum on an atypical site—the left buttock—with highly elevated c-ANCA levels, treated with multidrug therapy.

Giant idiopathic pyoderma gangrenosum at an unusual site with highly elevated c-ANCA levels: A rare association