Refractory pyoderma gangrenosum-like ulcerations in granulomatosis with polyangiitis treated successfully with rituximab

Granulomatosis with polyangiitis (GPA) is a small-to-medium vessel vasculitis that can affect the skin, respiratory tract, kidneys and other organs. A rare cutaneous manifestation of GPA is pyoderma gangrenosum (PG)-like ulcerations, which can have debilitating and disfiguring consequences. We report the case of a man in his 40s with refractory PG-like ulcerations secondary to GPA, not responsive to conventional immunosuppression, who was successfully treated with rituximab. This case emphasises the need for early recognition of this rare manifestation to allow for prompt initiation of treatment.