Koebner phenomenon in an ANCA-positive patient with pyoderma gangrenosum

Massimo Papi, Biagio Didona, Luca Massimo Chinni, Tommaso Gobello, Cinzia Mazzanti, Ornella De Pità, Rino Cavalieri

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A male with pyoderma gangrenosum is reported. The clinical and histological features were typical. The initial lesions resolved with characteristic cribriform scars. A few days after the complete recovery, he developed several necrotizing focal lesions localized to the scarred areas. A further histological examination revealed a granulation tissue rich in neutrophils and signs of necrotizing vasculitis. We found a high titer of circulating perinuclear antineutrophil antibodies (p-ANCA), which are a serological marker for various systemic diseases. An immunological circulating factor has been repeatedly suggested to be the 'primum movens' of pyoderma gangrenosum. We discuss the unusual clinical presentation interpreted as a Koebner phenomenon and the possible role of immune factors in enhancing circulating-endothelial cell interactions in relation to the pathogenesis of pyoderma gangrenosum.

Original languageEnglish
Pages (from-to)583-586
Number of pages4
JournalJournal of Dermatology
Issue number9
Publication statusPublished - Sep 1996


  • ANCA
  • Koebner phenomenon
  • Pyoderma gangrenosum
  • Vascular neoformation

ASJC Scopus subject areas

  • Dermatology

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    Papi, M., Didona, B., Chinni, L. M., Gobello, T., Mazzanti, C., De Pità, O., & Cavalieri, R. (1996). Koebner phenomenon in an ANCA-positive patient with pyoderma gangrenosum. Journal of Dermatology, 24(9), 583-586.