Pyoderma Gangrenosum Differential Diagnoses

Updated: Mar 09, 2020
  • Author: J Mark Jackson, MD; Chief Editor: William D James, MD  more...
  • Print

Diagnostic Considerations

Pyoderma gangrenosum is often misdiagnosed, and multiple attempts at grafting often occur prior to the diagnosis being made. The breakdown at the harvest site is a clue to the diagnosis and is an indicator of pathergy often seen in active pyoderma gangrenosum patients.

Conditions to consider in the differential diagnosis of pyoderma gangrenosum include the following:

  • Antiphospholipid antibody syndrome

  • Anthrax

  • Arterial insufficiency [18]

  • Acute febrile neutrophilic dermatosis (Sweet syndrome)

  • Blastomycosis

  • Factitial disease (see the image below)

    Factitial ulceration on the scalp from chronic man Factitial ulceration on the scalp from chronic manipulation mimicking an ulceration of pyoderma gangrenosum.
  • Traumatic ulceration

  • Tuberculosis gumma

  • Hidradenitis suppurativa

  • Insect bites

  • PAPA syndrome [19]

  • Sporotrichosis

  • Squamous cell carcinoma

  • Venous insufficiency [18]

  • Verrucous carcinoma

  • Wegener granulomatosis

  • Atypical mycobacterial infections

Differential Diagnoses