Woman Searches for Cause of Sores Spreading on her Face

Just days after Missy had a routine procedure to remove a cyst from her face, she noticed the site wasn’t healing and had begun to ooze fluid. Within a month, a large, open sore had spread across a third of her face, and eventually, another ulcer appeared on her upper arm.

“I started to feel like a zombie or a freak,” she says.

Missy has seen more than 30 doctors in the past two years in search of a diagnosis and a treatment. She has stopped going out with her husband and children and has hidden in her house. In the past two months, Missy has noticed the sores are continuing to spread across her face.

“It’s physically painful, but it’s definitely more emotionally painful,” she says.

The Doctors send Missy to see dermatologist Dr. Sonia Batra to see if she can offer any hope.

Dr. Batra finds that Missy has a rare inflammatory condition called pyoderma gangrenosum, in which the immune system becomes unregulated. The condition often is triggered by an injury.

“So the fact that she had that procedure to begin with set up this process that we call pathergy, where all these inflammatory cells rush to the area, but rather than healing the wound, they remain inflamed, and you develop chronic ulcers that don’t heal,” Dr. Batra explains.

People who have an underlying inflammatory condition such as rheumatoid arthritis are at a higher risk of developing pyoderma gangrenosum. It’s also associated with people who have ulcerative colitis or Crohn’s disease, which cause long-term inflammation along the digestive track.

Dr. Batra suggests treating Missy with a tumor-necrosis factor, or TNF, alpha inhibitor, which blocks the chemical in the body that stimulates inflammation. Dr. Batra says Missy should notice healing within two or three months.

Plastic surgeon Dr. Andrew Ordon adds that once the sores have begun to heal, there’s opportunity to treat the cosmetic appearance with lasers.

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