{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:00:28Z","timestamp":1785301228036,"version":"3.55.0"},"reference-count":16,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medical Case Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Pyoderma gangrenosum is a rare neutrophilic dermatosis characterized by painful ulcerative skin lesions and a lack of definitive diagnostic tests. It is frequently mistaken for infectious conditions, often resulting in inappropriate antibiotic use and delayed immunosuppressive therapy. To describe the clinical and demographic characteristics of patients with pyoderma gangrenosum initially assessed in an infectious diseases setting and identify patterns that may aid in earlier diagnosis and management. A retrospective case series was conducted at a Cellulitis Clinic. Patients with a PARACELSUS score \u2a7e10 were included. Ten patients met inclusion criteria. Median age was 61.5\u2009years; 60% were female and 90% Caucasian. Autoimmune diseases were present in 90%, mental health disorders in 50%, and endocrine abnormalities in 60%. Notably, 20% developed pyoderma gangrenosum at sites of healed scars\u2014a rare presentation. Early recognition and multidisciplinary management are essential for timely treatment and improved outcomes.<\/jats:p>","DOI":"10.1177\/2050313x261463941","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:13:31Z","timestamp":1785129211000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pyoderma gangrenosum presenting to an infectious diseases clinic: A 2024 case series"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5101-2277","authenticated-orcid":false,"given":"Fabiana","family":"Kellen","sequence":"first","affiliation":[{"name":"Schulich School of Medicine, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Silverman","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine, Western University, London, ON, Canada"},{"name":"Infectious Diseases Care Program, St. Joseph\u2019s Hospital, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4640-2561","authenticated-orcid":false,"given":"Esfandiar","family":"Shojaei","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine, Western University, London, ON, Canada"},{"name":"Infectious Diseases Care Program, St. Joseph\u2019s Hospital, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2410-6788","authenticated-orcid":false,"given":"MohammadReza","family":"Rahimi Shahmirzadi","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine, Western University, London, ON, Canada"},{"name":"Infectious Diseases Care Program, St. Joseph\u2019s Hospital, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0846-3534","authenticated-orcid":false,"given":"Lili","family":"Ataie","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine, Western University, London, ON, Canada"},{"name":"Infectious Diseases Care Program, St. Joseph\u2019s Hospital, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Al Ghazal P K\u00f6rber A Klode J et al. Investigation of new co-factors in 49 patients with pyoderma gangrenosum. J Dtsch Dermatol Ges 2012; 10(4): 251\u2013257. https:\/\/doi.org\/10.1111\/j.1610-0387.2011.07734.x","DOI":"10.1111\/j.1610-0387.2011.07734_suppl.x"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","unstructured":"Von den Driesch P. Pyoderma gangrenosum: a report of 44 cases with follow-up. Br J Dermatol 1997; 137(6): 1000\u20131005. https:\/\/doi.org\/10.1046\/j.1365-2133.1997.20022083.x","DOI":"10.1111\/j.1365-2133.1997.tb01568.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","unstructured":"Ahronowitz I Harp J Shinkai K. Etiology and management of pyoderma gangrenosum: a comprehensive review. Am J Clin Dermatol 2012; 13(3): 191\u2013211. https:\/\/doi.org\/10.2165\/11595240-000000000-00000","DOI":"10.2165\/11595240-000000000-00000"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","unstructured":"Maverakis E Ma C Shinkai K et al. Diagnostic criteria of ulcerative pyoderma gangrenosum: a Delphi consensus of international experts. JAMA Dermatol 2018; 154(4): 461\u2013466. https:\/\/doi.org\/10.1001\/jamadermatol.2017.5980","DOI":"10.1001\/jamadermatol.2017.5980"},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","unstructured":"Al Ghazal P Herberger K Schaller J et al. Associated factors and comorbidities in patients with pyoderma gangrenosum in Germany: a retrospective multicentric analysis in 259 patients. Orphanet J Rare Dis 2013; 8: 136. https:\/\/doi.org\/10.1186\/1750-1172-8-136","DOI":"10.1186\/1750-1172-8-136"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","unstructured":"Brooklyn T Dunnill G Probert C. Diagnosis and treatment of pyoderma gangrenosum. BMJ 2006; 333(7560): 181\u2013184. https:\/\/doi.org\/10.1136\/bmj.333.7560.181","DOI":"10.1136\/bmj.333.7560.181"},{"key":"e_1_3_2_8_2","doi-asserted-by":"crossref","unstructured":"Jockenh\u00f6fer F Wollina U Salva KA et al. The PARACELSUS score: a novel diagnostic tool for pyoderma gangrenosum. Br J Dermatol 2019; 180(3): 615\u2013620. https:\/\/doi.org\/10.1111\/bjd.16401","DOI":"10.1111\/bjd.16401"},{"key":"e_1_3_2_9_2","doi-asserted-by":"crossref","unstructured":"Binus AM Qureshi AA Li VW et al. Pyoderma gangrenosum: a retrospective review of patient characteristics comorbidities and therapy in 103 patients. Br J Dermatol 2011; 165(6): 1244\u20131250. https:\/\/doi.org\/10.1111\/j.1365-2133.2011.10565.x","DOI":"10.1111\/j.1365-2133.2011.10565.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"crossref","unstructured":"Alavi A French LE Davis MD et al. Pyoderma gangrenosum: an update on pathophysiology diagnosis and treatment. Am J Clin Dermatol 2017; 18(3): 355\u2013372. https:\/\/doi.org\/10.1007\/s40257-017-0251-7","DOI":"10.1007\/s40257-017-0251-7"},{"key":"e_1_3_2_11_2","doi-asserted-by":"crossref","unstructured":"Flora A Frew JW. Pyoderma gangrenosum: a review of the clinical mechanistic and therapeutic landscape. Wound Pract Res 2022; 30(1): 16\u201323. https:\/\/doi.org\/10.33235\/wpr.30.1.16-23","DOI":"10.33235\/wpr.30.1.16-23"},{"key":"e_1_3_2_12_2","doi-asserted-by":"crossref","unstructured":"Sasor SE Soleimani T Chu MW et al. Pyoderma gangrenosum demographics treatments and outcomes: an analysis of 2 273 cases. J Wound Care 2018; 27(suppl 1): S4\u2013S8. https:\/\/doi.org\/10.12968\/jowc.2018.27.Sup1.S4","DOI":"10.12968\/jowc.2018.27.Sup1.S4"},{"key":"e_1_3_2_13_2","doi-asserted-by":"crossref","unstructured":"Seo JW Son HH Choi JH et al. A case of p-ANCA-positive propylthiouracil-induced pyoderma gangrenosum. Ann Dermatol 2010; 22(1): 48\u201350. https:\/\/doi.org\/10.5021\/ad.2010.22.1.48","DOI":"10.5021\/ad.2010.22.1.48"},{"key":"e_1_3_2_14_2","doi-asserted-by":"crossref","unstructured":"Braswell SF Kostopoulos TC Ortega-Loayza AG. Pathophysiology of pyoderma gangrenosum (PG): an updated review. 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