Premenstrual flares of pyoderma gangrenosum controlled with use of a combined oral contraceptive and antiandrogen (ethinyl estradiol/drospirenone)

Summary The effect of sex hormones on pyoderma gangrenosum (PG) has not been reported. We report the case of a 34‐year‐old woman with chronic PG leg ulcers who was found to have recurring, premenstrual flares of PG. Her PG flares were controlled with the use of ethinyl estradiol/drospirenone. What's already known about this topic? The literature describes a positive role of oestrogen and a negative role of androgens, or androgen receptor activation, in cutaneous wound healing. There are reports of premenstrual flares in dermatological conditions such as hidradenitis suppurativa and acne vulgaris. What does this study add? Patients with pyoderma gangrenosum (PG) can have premenstrual PG flares. We were able to control our patient's premenstrual PG flares with the use of a combined oral contraceptive and antiandrogen (ethinyl estradiol/drospirenone).