Patient with disease initially manifesting as an episode of severe ulcerative colitis with important endoscopic involvement. The series shows continuous mucosal involvement affecting the entire colon, with large transmural ulcers presenting geographic margins. The patient presented gangrenous pyoderma in the region of the left ankle as extraintestinal manifestation of the disease.
Despite the seriousness of the disorder, the clinical condition of the patient, with no fever, no colon dilatation and acceptable laboratory test findings, led to the decision to administer anti-TNF treatment. This was followed by a very good clinical course, with colic mucosal healing and regression of the pyoderma.