TY - JOUR T1 - A Huge Pyoderma Gangrenosum-like Lesion as a Presenting Sign of Antiphospholipid Antibody Syndrome JF - The Journal of Rheumatology JO - J Rheumatol SP - 1557 LP - 1558 DO - 10.3899/jrheum.081182 VL - 36 IS - 7 AU - TAMMY HOD AU - ANETA LAZAROV AU - EVGENY EDELSTEIN AU - YAIR LEVY Y1 - 2009/07/01 UR - http://www.jrheum.org/content/36/7/1557.abstract N2 - To the Editor:The antiphospholipid antibody syndrome (APS) is associated with various cutaneous manifestations1 and leg ulceration is one of the most common. Cutaneous ulcers presenting as pyoderma gangrenosum (PG) have rarely been reported in this setting. Schmid, et al2 described a 64-year-old woman with systemic lupus erythematosus who presented with 2 large nonhealing ulcers on her right shank. PG associated with secondary APS was diagnosed2. Chacek, et al3 reported a 28-year-old man with PG and inferior vein syndrome due to thrombosis. A prolonged partial thromboplastin time and a positive test for circulating anticardiolipin antibodies led to the diagnosis of APS3. Schlesinger, et al reported 2 cases with an association between primary APS and PG-like skin lesions4.We describe a young man with a PG-like skin lesion. After evaluation to rule out PG-associated disorders, he was diagnosed with primary APS based on increased antibodies to cardiolipin and biopsy results. The ulcer healed completely.A 48-year-old Caucasian man presented with a necrotic ulcer … Address reprint requests to Dr. Hod; E-mail: tammyh{at}clalit.org.il ER -