Superficial granulomatous pyoderma (SGP), also known as vegetative pyoderma gangrenosum, is a rare, localized variant of pyoderma gangrenosum (PG). It typically presents as slowly progressive, superficial ulcerations with a vegetative border and clean base, most often on the trunk. Unlike classic PG, SGP is usually not associated with systemic disease, follows an indolent course, and may respond to topical or conservative systemic therapy. Histopathology can be variable; reported features include a zoned neutrophilic infiltrate in the upper dermis and occasional sinus tract formation. We report a diagnostically challenging case of SGP in a 91-year-old Chinese woman who presented with a three-year history of pruritic, superficial ulcerated plaques. Multiple biopsies and cultures initially yielded nonspecific results, with findings obscured by prior topical treatment and colonization of chronic wounds. A definitive diagnosis was achieved only after biopsy of a new, untreated lesion, which demonstrated ulceration with dermal neutrophilic infiltrate. The patient subsequently improved on topical clobetasol and low-dose doxycycline monohydrate. This case highlights the importance of clinicopathologic correlation, the value of obtaining biopsies from fresh, untreated lesions, and the potential role of conservative therapies in elderly patients with SGP.
- Open Access
- Case Report
A Challenging Case of Superficial Granulomatous Pyoderma in a 91-Year-Old Chinese Female
Author Information
Received: 23 Feb 2026 | Revised: 26 Mar 2026 | Accepted: 28 Apr 2026 | Published: 01 Jun 2026
Abstract
Keywords
superficial pyoderma gangrenosum | superficial granulomatous pyoderma | topical corticosteroid | clobetasol | doxycycline monohydrate
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