{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:28:02Z","timestamp":1767140882590,"version":"3.48.0"},"reference-count":19,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,12]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>We report a rare case of concurrent cutaneous and prostatic pyoderma gangrenosum (PG) in a man in his 70s. The patient initially presented with dysuria, pelvic discomfort and a boggy prostate, consistent with bacterial prostatitis. Despite prolonged antibiotic therapy, his symptoms progressed and imaging revealed a prostatic abscess. Following transurethral resection of the prostate, he developed painful necrotic ulcers across the trunk and extremities. Histopathological examination of both the prostate and skin demonstrated sterile neutrophilic inflammation, consistent with PG. Dermatology initiated systemic corticosteroids, mycophenolate mofetil and infliximab, resulting in partial disease control. This case highlights a unique presentation of simultaneous visceral and cutaneous PG in the absence of prior trauma or surgery and underscores the importance of considering non-infectious neutrophilic dermatoses in patients with refractory prostatitis and evolving systemic inflammation.<\/jats:p>","DOI":"10.1136\/bcr-2025-269359","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T18:05:19Z","timestamp":1767117919000},"page":"e269359","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Multi-organ pyoderma gangrenosum presenting as refractory prostatitis"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3956-5573","authenticated-orcid":false,"given":"Ayushya","family":"Ajmani","sequence":"first","affiliation":[{"name":"Student, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristan","family":"Schiele","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan J","family":"Badin","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaofeng","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence","family":"Dagrosa","sequence":"additional","affiliation":[{"name":"Department of Urology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2347-5602","authenticated-orcid":false,"given":"Alicia T","family":"Dagrosa","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"2025123016250932000_18.12.e269359.1","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1001\/jamadermatol.2017.5980","article-title":"Diagnostic Criteria of Ulcerative Pyoderma Gangrenosum: A Delphi Consensus of International Experts","volume":"154","author":"Maverakis","year":"2018","journal-title":"JAMA Dermatol"},{"key":"2025123016250932000_18.12.e269359.2","doi-asserted-by":"publisher","DOI":"10.2165\/11595240-000000000-00000"},{"key":"2025123016250932000_18.12.e269359.3","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1016\/j.jaad.2019.09.032","article-title":"Pyoderma gangrenosum in hematologic malignancies: A systematic review","volume":"82","author":"Montagnon","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"2025123016250932000_18.12.e269359.4","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21409"},{"key":"2025123016250932000_18.12.e269359.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2019.08.001"},{"key":"2025123016250932000_18.12.e269359.6","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s13691-018-0332-3","article-title":"Pyoderma gangrenosum after radical prostatectomy: case report","volume":"7","author":"Osaka","year":"2018","journal-title":"Int Cancer Conf J"},{"key":"2025123016250932000_18.12.e269359.7","first-page":"565","article-title":"A case of pyoderma gangrenosum involving the prostate gland after radiation therapy for prostate cancer","volume":"48","author":"Kanno","year":"2002","journal-title":"Hinyokika Kiyo"},{"key":"2025123016250932000_18.12.e269359.8","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.eururo.2005.11.017","article-title":"Prostatic infarction involving the urinary sphincter, an association with pyoderma gangrenosum","volume":"49","author":"van de Riet","year":"2006","journal-title":"Eur Urol"},{"key":"2025123016250932000_18.12.e269359.9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.reuma.2011.07.003","article-title":"Pyoderma gangrenosum associated with inflammatory bowel disease","volume":"8","author":"Carrasco Cubero","year":"2012","journal-title":"Reumatol Clin"},{"key":"2025123016250932000_18.12.e269359.10","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s00108-015-0004-8","article-title":"Multiple abscesses after a cruise along the Latin American coast","volume":"57","author":"Reynolds","year":"2016","journal-title":"Internist (Berl)"},{"key":"2025123016250932000_18.12.e269359.11","article-title":"Pyoderma gangrenosum post open radical prostatectomy - A complication every urologist should consider and recognise","volume":"54","author":"MacDiarmid","year":"2024","journal-title":"Urol Case Rep"},{"key":"2025123016250932000_18.12.e269359.12","doi-asserted-by":"crossref","DOI":"10.1097\/GOX.0000000000005505","article-title":"Postsurgical Pyoderma Gangrenosum Requiring Plastic Surgical Intervention: A Practical Review","volume":"12","author":"Guliyeva","year":"2024","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2025123016250932000_18.12.e269359.13","doi-asserted-by":"crossref","first-page":"224","DOI":"10.7861\/clinmedicine.19-3-224","article-title":"Pyoderma gangrenosum \u2013 a guide to diagnosis and management","volume":"19","author":"George","year":"2019","journal-title":"Clin Med (Northfield)"},{"key":"2025123016250932000_18.12.e269359.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2015.06.021"},{"key":"2025123016250932000_18.12.e269359.15","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1007\/s40257-022-00699-8","article-title":"Pyoderma Gangrenosum: An Updated Literature Review on Established and Emerging Pharmacological Treatments","volume":"23","author":"Maronese","year":"2022","journal-title":"Am J Clin Dermatol"},{"key":"2025123016250932000_18.12.e269359.16","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1111\/bjd.13493","article-title":"The genetics of pyoderma gangrenosum and implications for treatment: a systematic review","volume":"172","author":"DeFilippis","year":"2015","journal-title":"Br J Dermatol"},{"key":"2025123016250932000_18.12.e269359.17","unstructured":"Pyoderma gangrenosum with visceral involvement: a severe, recurrent disease affecting pulmonary, splenic, mesorectal, and subcutaneous tissues. 2025. Available: https:\/\/www.mp.pl\/paim\/issue\/article\/15368"},{"key":"2025123016250932000_18.12.e269359.18","doi-asserted-by":"publisher","DOI":"10.1177\/2042018816641580"},{"key":"2025123016250932000_18.12.e269359.19","doi-asserted-by":"crossref","DOI":"10.2340\/actadv.v104.42018","article-title":"Living with Pyoderma Gangrenosum: A Qualitative Study","volume":"104","author":"Jiang","year":"2024","journal-title":"Acta Derm Venereol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269359","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:25:20Z","timestamp":1767140720000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":19,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,30]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-269359"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269359","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}