A 45-year-old woman with Crohn's disease develops multiple, rapidly extending, painful ulcers on both legs with raised, undermined, purplish-blue borders. Wound culture is sterile. The FIRST-LINE systemic treatment of choice is:
- A High-dose systemic corticosteroids (prednisolone 1 mg/kg/day) ✓
- B Oral doxycycline 100 mg twice daily
- C Surgical debridement under general anaesthesia
- D Intravenous amphotericin B
Correct answer: A. High-dose systemic corticosteroids (prednisolone 1 mg/kg/day)
Explanation
This clinical scenario is pyoderma gangrenosum (PG) complicating Crohn's disease. High-dose systemic corticosteroids (prednisolone 0.5–1 mg/kg/day) are first-line treatment. Cyclosporin is the alternative immunosuppressant for steroid-refractory cases. Infliximab is also effective, particularly in IBD-associated PG. Surgical debridement is CONTRAINDICATED due to pathergy—it triggers expansion of ulcers. Antibiotics and antifungals have no role in this neutrophilic dermatosis.
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.