A four-year old-child with widespread pyoderma gangrenosum resistant to topical treatment.

Pyoderma Gangrenosum (PG) is an uncommon inflammatory disease preferentially affecting middle-aged women; children account for 4-5% of reported cases [1]. It usually presents as painful pustules, blisters or nodules that enlarge and evolve into deep ulcers, eventually healing with cribriform scars. Lesions generally arise on the legs in adults and older children and in the perineum or face in younger patients. The differential diagnosis includes vasculitis, infections, malignancies and factitious ulcers. Nearly half of cases are associated with inflammatory bowel disease (IBD), neoplasms, rheumatic or haematological disorders. The course of the disease can be malignant, chronic or relapsing, usually receding with treatment of the associated disease [2]. We report the case of a child with PG lesions at multiple sites but no associated disease, who responded to systemic treatment with steroid boluses.