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Pyoderma Gangrenosum
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Pyoderma Gangrenosum

En Español (Spanish Version)

Definition

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

Skin Ulcer small

© 2008 Nucleus Medical Art, Inc.

Causes

Pyoderma gangrenosum is thought to be an autoimmune disorder, which means it occurs when the body's immune system attacks its own tissues.

Risk Factors

Pyoderma gangrenosum is more likely to occur in people who have other underlying medical conditions, including:

Ulcerative Colitis

Ulcerative Colitis

© 2008 Nucleus Medical Art, Inc.

Symptoms

The chief symptom of pyoderma gangrenosum is painful skin ulcers. These ulcers may begin as small pustules, often as the site of a minor injury, but they can enlarge up to 20 centimeters (or 7.9 inches). The ulcers may have a characteristic purple, rolled or undermined edge.

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. He or she will refer you to a dermatologist, who specializes in conditions of the skin. Pyoderma gangrenosum is diagnosed by its appearance and by ruling out other causes of skin ulceration. Tests may include the following:

  • Swabs to test for microorganisms
  • Biopsy—removal of a sample of tissue to rule out other causes of the ulcers
  • Blood tests

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Steroid Medications and Cyclosporine

For most cases of pyoderma gangrenosum , steroid medications and cyclosporine are the first line of treatment. These medications are used to help suppress the body's immune system.

Steroid Creams or Injections

Topical steroid creams or injections of steroid into the lesion may help treat small ulcers.

Other Medications

Other medications have shown promise in treating pyoderma gangrenosum . These medications include:

  • Infliximab
  • Etanercept
  • Adalimumab
  • Colchicines
  • Mycophenolate Mofetil
  • Tacrolimus
  • Cyclophosphamide

Prevention

There is no known way to prevent pyoderma gangrenosum , but people who have the condition can reduce the chance of getting new ulcers by avoiding injuring the skin.

RESOURCES:

American Academy of Dermatology
http://www.aad.org/default.htm

American Autoimmune Related Diseases Association
http://www.aarda.org

CANADIAN RESOURCES:

Canadian Dermatology Association
http://www.dermatology.ca

Canadian Institute for Health Information
http://www.cihi.ca/cihiweb

References:

Charles CA, Leon A, Banta MR, Kirsner RS. Etanercept for the treatment of refractory pyoderma gangrenosum: a brief series. Int J Dermatol . 2007 Oct;46(10):1095-9.

Pyoderma gangrenosum . DermNet NZ website. Available at: http://dermnetnz.org/reactions/pyoderma-gangrenosum.html. Accessed February 27, 2007.

Pyoderma gangrenosum . DynaMed website. Available at: http://dynamed101.epnet.com/Detail.aspx?id=113752. Accessed February 27, 2007.

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. Review.



Last reviewed March 2008 by Ross Zeltser, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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