DefinitionA skin ulcer is an open sore in the skin. Pyoderma gangrenosum is an uncommon form of skin ulcers. It usually occurs on the lower legs, but can occur anywhere on the skin.
|Side View of Skin Ulcer|
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CausesPyoderma gangrenosum is thought to be caused by a problem with the immune system. The immune system finds and attacks foreign items in the body like viruses. Sometimes the immune system attacks the body's own tissue. In this case, the immune system attacks an area of the skin.
Risk FactorsPyoderma gangrenosum is more likely to occur in people who have other underlying medical conditions, such as:
- Ulcerative colitis
- Crohn's disease
- Chronic active hepatitis
- Rheumatoid arthritis
- Polycythemia vera
- Behcet's syndrome
- Acute myelogenous leukemia
- Chronic myelogenous leukemia
SymptomsThe main symptom of pyoderma gangrenosum is a painful skin ulcer. These ulcers may begin as small-irritated bumps from an injury. However, the ulcer can grow up to 7.9 in (inches) (20 cm [centimeters]). The ulcers often have purple edges that appear worn away.
DiagnosisYour doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a skin specialist. Pyoderma gangrenosum is diagnosed by its appearance. Your doctor will also want to rule out other conditions that can cause skin ulcers.To look for other factors that could cause ulcers, your doctor may order:
- Sample of ulcer fluids—to look for infection or items that can cause infection
- Biopsy —a tissue sample examined under a microscope
- Blood tests
TreatmentTalk with your doctor about the best treatment plan for you. Treatment options include:
MedicationsMedications to treat pyoderma gangrenosum include:
- Oral corticosteroids
- Smaller ulcers may be treated with a topical steroid cream or an injection
Preventing New UlcersUlcers often begin at the site of injuries. Take precaution to prevent injuries when possible. Wear proper safety gear and avoid high impact or full contact activities.See your doctor as soon as you notice a possible ulcer.
PreventionThere are no current guidelines to prevent pyoderma gangrenosum.
American Academy of Dermatology
American Autoimmune Related Diseases Association
Canadian Dermatology Association
Canadian Institute for Health Information
Charles CA, Leon A, et al. Etanercept for the treatment of refractory pyoderma gangrenosum: a brief series. Int J Dermatol. 2007 Oct;46(10):1095-1099.
Pyoderma gangrenosum. DermNet NZ website. Available at: http://www.dermnetnz.org/reactions/pyoderma-gangrenosum.html. Accessed December 7, 2012.
Pyoderma gangrenosum. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 14, 2012. Accessed December 7, 2012.
Reguiaï Z, Grange F. The role of anti-tumor necrosis factor-alpha therapy in Pyoderma gangrenosum associated with inflammatory bowel disease. Am J Clin Dermatol. 2007;8(2):67-77.
- Reviewer: Marcin Chwistek, MD
- Review Date: 12/2014
- Update Date: 12/20/2014