Sunday, October 9, 2016

Pyoderma Gangrenosum

Pyoderma gangrenosum is a rapidly evolving and severely debilitating skin disease that is characterized by a painful hemorrhagic pustule that breaks down to form a chronic ulcer. The ulcer is associated with pus production, and there is usually a dusky red or purple halo around the ulcer.



The cause of the lesions is unknown, but they tend to form at the sites of trauma (most commonly the legs).

Clinical Features: The borders of the lesions are usually irregular, and the lesions are boggy and usually quite painful.

Association With Other Medical Conditions: Although as many as 50% of cases have no associated underlying abnormality, other diseases associated with pyoderma gangrenosum include

  • Crohn’s disease, 
  • ulcerative colitis, 
  • leukemia, 
  • paraproteinemia, 
  • multiple myeloma, 
  • rheumatoid arthritis, 
  • hepatitis, and
  • Behcet’s disease. 

Additional findings in these patients include cutaneous anergy and benign monoclonal gammopathy.

The diagnosis of pyoderma gangrenosum is usually made by the history and clinical findings. Laboratory tests show elevated ESR and leukocytosis.

Treatment involves correction of underlying disease and the use of high dose oral steroids or intravenous pulse steroid therapy.

1 comment:

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