# Facial Pyoderma Gangrenosum Revealing Inflammatory Bowel Disease After Prior Total Colectomy

## TL;DR

A rare facial skin condition revealed an underlying inflammatory bowel disease in a patient who had previously undergone a total colectomy.

## Contribution

This case highlights the diagnostic importance of considering IBD in PG patients despite misleading surgical history.

## Key findings

- Facial PG occurred at the site of a prior cosmetic thread lift.
- PG led to a diagnosis of IBD despite a history of total colectomy.
- Clinicians should evaluate for underlying conditions in PG patients regardless of prior surgery.

## Abstract

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis associated with systemic conditions such as inflammatory bowel disease (IBD) and hematologic malignancy. Lesions classically present on the lower extremities and rarely arise on the face. We report an unusual case of facial PG that developed at the site of a prior cosmetic thread lift. The lesions ultimately led to a diagnosis of underlying IBD despite the patient’s history of a total colectomy following complications from a non-IBD related procedure. This case highlights that clinicians must always evaluate for underlying conditions in patients with PG, even when symptoms are absent or surgical history is misleading.