Recalcitrant skin ulcers in a patient with Papillon–Lefèvre syndrome: an unusual novel presentation

We discuss an unusual presentation of Papillon–Lefèvre syndrome (PLS) in a 23-year-old man featuring recalcitrant pyoderma gangrenosum-like ulcers, a symptom not previously associated with PLS. Genetic testing identified a novel homozygous pathogenic variant in CTSC responsible for PLS, highlighting the importance of considering this diagnosis in patients with treatment-resistant skin ulcers. This case broadens our understanding of PLS and its diverse clinical manifestations.