Pyoderma Gangrenosum |
Pyoderma gangrenosum (PG) is an uncommon, recurrent and chronic skin disease characterized by its distinct chronic ulcer. Initial lesions may resemble small bug bites or papules that eventually develop deep ulceration and chronic wounds. Since the clinical manifestations vary based on the individual and underlying cause, a biopsy may be required to make a definitive diagnosis.
Although a strong association is seen with underlying systemic or immunologic diseases, approximately 25-50% of cases remain idiopathic. Currently, experts attribute PG to failing neutrophilic function, or a humoral and cell-mediated immunity dysfunction; however these findings have not been consistently demonstrated. One of the most unique cutaneous features of PG, found also in Behcet’s disease, is known as pathergy. Pathergy is a condition where the appearance of an exaggerated skin lesion arises secondarily to minor trauma such as scratches, bumps and needle pricks. Although both PG and Behcet’s disease demonstrate pathergy, the lesions seen in PG are often responsive to topical steroids, whereas those in Behcet’s are not.
No uniform or specific therapy exists for PG, and therefore treatment regimes can vary among dermatologists. Guiding factors in choosing a therapeutic approach include size, number, depth, rate of expansion and any associated underlying disease. The mainstay of treatment has traditionally been local and or systemic corticosteroids, which aim at reducing the inflammatory nature of the wound. In cases demonstrating resistance to corticosteroids, both tacrolimus and cyclosporine have been used.
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2/27/2018MACRA/MIPS Update
10/12/2017Foundation for Osteopathic Dermatology
7/6/2016Disclosure to members regarding CME activities
4/3/2014The Burning Truth
12/19/2013Osteopathic Training Statement
10/9/2018 » 10/13/2018
2018 AOCD Fall Current Concepts in Dermatology Meeting
4/9/2019 » 4/13/2019
2019 AOCD Spring Current Concepts in Dermatology Meeting
9/24/2019 » 9/28/2019
2019 AOCD Fall Current Concepts in Dermatology
2/19/2020 » 2/22/2020
2020 AOCD Spring Current Concepts in Dermatology
2/24/2021 » 2/27/2021
2021 AOCD Spring Current Concepts in Dermatology