Diagnostic pitfalls in the differentiation between pyoderma gangrenosum and necrotizing fasciitis


necrotizing fasciitis; pyoderma gangrenosum

Published online: Mar 30 2019

Yves Fortems , Pieter De Witte , Erwin Jansegers

From the Department of Orthopedics, “Groep Orthopedie”, GZA Hospitals, Campus Sint-Augustinus, Wilrijk and Sint-Jozef Hospital, Malle, Belgium


Pyoderma gangrenosum and necrotizing fasciitis are two rare pathologic entities with a similar clinical image, but a who require a very different management. In general physicians, orthopedics, dermatologists, plastic surgeons will hardly ever see it, but when they do it is very important to distinguish between both. In this paper with the focus on the practical approach ,we expose the diagnostic pitfalls in the differential diagnosis, explain how to prevent them and summarize the evidence on therapeutic management. To achieve this we use a case where the diagnosis was rather difficult and utilize reviews where the clinical features, early diagnostic tools and treatment options are explained.