Pyoderma Gangrenosum-like Ulcers Associated Granulomatosis with Polyangiitis

Granulomatosis with polyangiitis is an ANCA-positive vasculitis primarily affecting small to medium-sized vessels, typically involving the lungs and kidneys. This article presents a remarkable case of a patient with an unusual pyoderma gangrenosum-like ulcer on the face and granulomatosis with polyangiitis.  A 28-year-old man, previously diagnosed with granulomatosis with polyangiitis presented at a dermatology clinic with a 6-month-old ulcer in the right preauricular region following a traumatic incident. A spindle biopsy revealed suppurative granulomatous dermatitis with secondary vascular damage, while cultures showed no signs of infection. The patient was subsequently treated with rituximab, leading to a positive clinical response. This case underscores the challenge of diagnosing this rare manifestation of granulomatosis with polyangiitis and suggests that rituximab could be a valuable treatment option.