Case Report
Pyoderma Gangrenosum—A New Manifestation of Wilson Disease?

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Seventeen year old girl, a known case of Wilson disease presented to us with a non-healing skin ulcer followed by appearance of jaundice, ascites and progressive fatigue of 1 month duration. She was diagnosed to have Wilson disease 5 years back and had been well controlled on d-penicillamine. On enquiry, she was found to be noncompliant with her medication in the preceding 6 months. On examination, she had severe pallor, icterus with moderate ascites and oedema feet. Investigations revealed severe haemolytic anemia and deranged liver function. The lesion was diagnosed to be pyoderma gangrenosum on skin biopsy. The appearance of a cutaneous lesion followed by deterioration in the liver disease and hemolysis suggested uncontrolled Wilson disease as the triggering factor. Chelation therapy improved her haemoglobin and liver function as well as led to healing of the ulcer. We describe pyoderma gangrenosum as a new manifestation of Wilson disease.

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Case

A 17-year-old girl, born out of non-consanguineous marriage, was apparently alright until a month prior to the presentation. She had developed pustules over left calf, which broke down to form a non-healing raw area. Local treatment of the ulcer had not helped. This was followed 2 weeks later by fatigue, weakness and yellowish discoloration of eyes. She was a known case of Wilson disease since the last 5 years and was well controlled on d-penicillamine. On enquiry, she revealed that she was

Conflicts of interest

The authors have none to declare.

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Cited by (1)

  • Skin manifestations associated with systemic diseases – Part II

    2021, Anais Brasileiros de Dermatologia
    Citation Excerpt :

    A greater number of subcutaneous lipomas has been observed in patients with WD; however, their pathophysiology remains to be elucidated.27 Freg et al., in 2016, described the case of a 17-year-old female patient who developed pyoderma gangrenosum.28 Many skin conditions can be correlated with internal malignancies in specific or non specific ways.

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