{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T04:15:23Z","timestamp":1778818523171,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pyoderma gangrenosum (PG) is a rare, ulcerative neutrophilic dermatosis that presents significant diagnostic challenges due to its clinical heterogeneity and lack of definitive laboratory markers. Misdiagnosis often leads to inappropriate treatments, delayed recovery, and increased morbidity. We report two cases of PG at opposite ends of the age spectrum\u2014a 90\u2010year\u2010old male and a 10\u2010year\u2010old boy\u2014each initially misdiagnosed as chronic infective ulcers. Both patients demonstrated classical features of PG, including rapid ulcer progression, pathergy phenomenon, undermined violaceous borders, and non\u2010responsiveness to antimicrobial therapy. Despite the absence of histopathological confirmation, clinical diagnosis was established using the Delphi Consensus Criteria (2018), with both cases fulfilling seven of eight minor diagnostic criteria. Initiation of systemic corticosteroids led to rapid and sustained clinical improvement, underscoring the role of early immunosuppressive therapy. These cases highlighted the critical importance of considering PG in patients with non\u2010healing ulcers unresponsive to standard therapy, particularly when pathergy and clinical red flags are present. Clinicians should adopt a high index of suspicion and utilize validated diagnostic frameworks to avoid unnecessary interventions and optimize patient outcomes, especially in atypical age groups.<\/jats:p>","DOI":"10.1002\/ccr3.72712","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T03:49:15Z","timestamp":1778816955000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pyoderma Gangrenosum Masquerading as Chronic Infective Ulcers: Two Case Reports Across Age Extremes"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2633-2905","authenticated-orcid":false,"given":"Amrit","family":"Neupane","sequence":"first","affiliation":[{"name":"Sukraraj Tropical &amp; Infectious Disease Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivendra Kumar","family":"Jha","sequence":"additional","affiliation":[{"name":"Sukraraj Tropical &amp; Infectious Disease Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anisha","family":"Basukala","sequence":"additional","affiliation":[{"name":"Sukraraj Tropical &amp; Infectious Disease Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0919-212X","authenticated-orcid":false,"given":"Nishan","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Dhading Hospital  Dhading Besi Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8759-9887","authenticated-orcid":false,"given":"Aashish","family":"Neupane","sequence":"additional","affiliation":[{"name":"Loyala Medicine MacNeal Hospital  Berwyn Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750\u20101172\u20102\u201019\/FIGURES\/4"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.7861\/CLINMEDICINE.19\u20103\u2010224"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/S40257\u2010022\u201000699\u20108"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/IWJ.13389"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/IJMS25042440"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMADERMATOL.2017.5980"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2023.12.002"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S61202"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1468\u20103083.2009.03199.X"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.BJPS.2014.12.036"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/S40265\u2010023\u201001931\u20103"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/ASW.0000000000000129"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00403\u2010024\u201003689\u20104"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/S13671\u2010023\u201000388\u20107\/FIGURES\/2"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/IJD.13584"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.35279\/JOWM2023.24.02.05"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/IWJ.70733"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/J.1365\u20104362.2002.01329.X"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72712","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72712","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72712","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T03:49:25Z","timestamp":1778816965000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72712"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/ccr3.72712"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72712","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72712"}}