# Post-surgical Pyoderma Gangrenosum Reveals Celiac Disease in a Pediatric Patient

## TL;DR

A teenage girl developed a rare skin condition after surgery, which led to the diagnosis of celiac disease, highlighting a rare connection in children.

## Contribution

This case is the first reported instance of post-surgical pyoderma gangrenosum revealing celiac disease in a pediatric patient.

## Key findings

- Post-surgical pyoderma gangrenosum was linked to an undiagnosed celiac disease in a 13-year-old girl.
- Celiac disease was confirmed through positive serology and duodenal biopsy.
- The patient improved with topical corticosteroids and wound care.

## Abstract

Pyoderma gangrenosum (PG) is a rare, autoinflammatory neutrophilic dermatosis that may be triggered by cutaneous trauma and is frequently associated with systemic diseases, most commonly inflammatory bowel disease. Celiac disease (CD), an immune-mediated enteropathy precipitated by gluten, is not typically linked with PG, particularly in the pediatric population. We present a highly unusual case of a 13-year-old female who developed post-surgical PG following excision of an epidermoid cyst, ultimately leading to a new diagnosis of CD. Histopathology and clinical features were consistent with PG, with no evidence of infection. The patient was successfully managed with topical corticosteroids and wound care. Subsequent gastrointestinal evaluation revealed positive celiac serologies and confirmatory duodenal biopsy findings. This case highlights the importance of recognizing PG as a potential cutaneous manifestation of undiagnosed CD in pediatric patients and the need for a multidisciplinary approach to prompt diagnosis and treatment.