Case Report: Cutaneous Leishmaniasis Misdiagnosed as Pyoderma Gangrenosum

With an estimated prevalence of 0.7%, pyoderma gangrenosum (PG) is the most frequent type of reactive skin lesions seen in the setting of inflammatory bowel disease, together with metastatic Crohn's disease. However, in the case of persistent cutaneous ulcerations in patients with Crohn's disease under biologic and/or immunosuppressive therapy, infectious or malignant etiologies should be excluded. We report a case of multiple difficult-to-treat skin ulcerations due to Leishmania in a patient with Crohn's disease treated with antitumor necrosis factor-alpha drugs, misinterpreted for a long time as PG.

Automated summary

Pyoderma gangrenosum is the most common type of reactive skin lesions in patients with inflammatory bowel disease, but infectious or malignant causes should be considered in cases of persistent cutaneous ulcerations despite treatment with biologic and immunosuppressive therapy.