Pyoderma gangrenosum breast with leukaemoid reaction: a rare clinical entity

Breast ulceration is an alarming sign for clinicians and it places a significant physical and psychological burden on the patient. We report the rare presentation of Pyoderma gangrenosum (PG) of the breast with secondary leukaemoid reaction. A 26-year-old lady was referred to us from medicine department for evaluation of recurrent ulcers involving both breasts for the last three months. Physical examination revealed symmetrical bilateral ulcers on both breasts; nipples were spared. The total leucocyte count was high (40,800/mm3). Patient was thoroughly investigated to rule out any associated systemic disorder. Based on the clinical presentation and haematological picture a diagnosis of PG with leukaemoid reaction was made. Patient was treated with systemic steroids, clofazimine and topical immunomodulators. After 6 weeks of treatment, the ulcers resolved significantly and her leucocyte count became normal. The patient is on regular follow-up and is doing well.