A case of propylthiouracil-induced pyoderma gangrenosum associated with antineutrophil cytoplasmic antibody

Dermatology. 2004;208(4):339-41. doi: 10.1159/000077844.


A 27-year-old woman who had been receiving propylthiouracil for 2 years for Graves' disease presented with painful ulceration on the lower limbs which had first appeared 2 weeks previously. Well-circumscribed hemorrhagic ulcerations with ragged borders were noted on both legs. Skin biopsy demonstrated a florid neutrophilic infiltrate and evidence of leukocytoclasis around small blood vessels in the papillary dermis compatible with the diagnosis of pyoderma gangrenosum. A highly positive perinuclear pattern of antineutrophil cytoplasmic antibody with specificities for IgM myeloperoxidase was observed. The authors think that propylthiouracil is associated with the occurrence of pyoderma gangrenosum in this patient.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Antineutrophil Cytoplasmic / immunology*
  • Antithyroid Agents / adverse effects*
  • Diagnosis, Differential
  • Female
  • Graves Disease / drug therapy*
  • Humans
  • Leg Ulcer / chemically induced
  • Leg Ulcer / diagnosis
  • Leg Ulcer / immunology
  • Propylthiouracil / adverse effects*
  • Pyoderma Gangrenosum / chemically induced
  • Pyoderma Gangrenosum / diagnosis*
  • Pyoderma Gangrenosum / immunology


  • Antibodies, Antineutrophil Cytoplasmic
  • Antithyroid Agents
  • Propylthiouracil