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Pyoderma gangrenosum (PG) is a relatively rare neutrophilic dermatosis, characterized by progressive skin necrosis. It typically has a chronic course, of unknown etiology. Pyoderma gangrenosum diagnosis can be difficult because both histopathological examination and results of additional laboratory tests are not specific and the clinical state is conclusive, as for other physicians it poses a number of diagnostic dilemmas. Therefore, this condition should be treated interdisciplinary. We present a case of a 40-year-old patient with a diagnosis of PG, which in the early stages of the disease was treated as an extensive phlegmon by physicians of other specialties and it presented a serious diagnostic as well as therapeutic problem.

Pseudoporphyria is a condition identical to porphyria cutanea tarda (PCT) on clinical and histological grounds, but without any biochemical porphyrin abnormality. Excessive sunlight and UVA exposure (for example tanning beds), drugs such as: non-steroidal anti-inflammatory drugs, retinoids, antibiotics, diuretics and others are supposed to be etiological factors of pseudoporphyria. Cases of PCT and pseudoporphyria in patients with HCV infection and hemodialysed due to chronic renal failure were also described. Here, we describe a clinical case of a 57-year-old patient, who developed cutaneous changes on the face and the dorsal surfaces of hands clinically and histologically characteristic of PCT but with normal levels of urine porphyrins.