Pyoderma gangrenosum (PG) demonstrates pathergy. A surgeon performing debridement of a suspected PG ulcer on the leg of a patient with ulcerative colitis would most likely observe which outcome?

• A Accelerated healing because necrotic tissue is removed
• B Conversion to a squamous cell carcinoma
• C Paradoxical worsening of the ulcer due to pathergy phenomenon ✓
• D Spontaneous resolution of the remaining wound within 48 hours

Explanation

Pathergy — the exaggerated skin response to minor trauma — is a defining feature of pyoderma gangrenosum. Surgical debridement or incision triggers expansion of the ulcer, a phenomenon known as pathergy, making surgery contraindicated. First-line treatment is immunosuppression (systemic steroids, cyclosporine, infliximab) and wound care without debridement. This is a frequently tested concept in NEET PG.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.