Materiały źródłowe

• #1 Pyoderma gangrenosum – Wikipedia

  https://en.wikipedia.org/wiki/Pyoderma_gangrenosum

  Pyoderma gangrenosum is a rare, inflammatory skin disease where painful pustules or nodules become ulcers that progressively grow. […] The disease was identified in 1930. It affects approximately 1 person in 100,000 in the population. Though it can affect people of any age, it mostly affects people in their 40s and 50s. […] One hallmark of pyoderma gangrenosum is pathergy, which is the appearance of new lesions at sites of trauma, including surgical wounds. […] Diagnosis of PG is challenging owing to its variable presentation, clinical overlap with other conditions, association with several systemic diseases, and absence of defining histopathologic or laboratory findings. Misdiagnosis and delayed diagnosis are common. It has been shown that up to 39% of patients who initially received a diagnosis of PG have an alternative diagnosis. […] First-line therapy for disseminated or localized instances of pyoderma gangrenosum is systemic treatment with corticosteroids and ciclosporin.

• #2 Pyoderma gangrenosum – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/pyoderma-gangrenosum/

  Pyoderma gangrenosum usually occurs in young to middle-aged adults. The appearance of the condition may vary. It may start as a small pimple, red bump, pustule or blood-blister. The skin usually breaks down to form an ulcer which often oozes fluid. The ulcer can enlarge rapidly. The edge of the ulcer may look purplish. Once the ulcer has healed, the resulting scar may be darker than the surrounding skin (hyperpigmented), pale, thin and wrinkled in appearance or pitted. […] There is usually a single large ulcer. Occasionally there may be multiple ulcers. Ulcers may become infected, oozing fluid or pus. Pain or discomfort from the ulcer is common. Pyoderma gangrenosum is not a skin cancer and does not lead to cancer.

• #3 Pyoderma Gangrenosum: Symptoms, Causes, and Treatment — DermNet

  https://dermnetnz.org/topics/pyoderma-gangrenosum

  Pyoderma gangrenosum (PG) presents as a rapidly enlarging, very painful ulcer. It is characterised by a full-thickness ulcer with blue/purple undermined borders and by pathergy. […] Pyoderma gangrenosum usually starts quite suddenly, often at the site of a minor injury. It may start as a small pustule, red bump, or blood-blister, often misinterpreted as an insect bite. The skin then breaks down resulting in an ulcer. The ulcer can deepen and widen rapidly. Characteristically, the edge of the ulcer is purple and undermined. Pyoderma gangrenosum is usually very painful. Several ulcers may develop at the same time or over months to years. […] Untreated, the ulcers may continue to enlarge, persist unchanged, or may slowly heal. Treatment is usually successful in arresting the process, but complete healing may take months. This is particularly true if there is an underlying venous disease, another reason for leg ulcers. Deep ulcers heal with scarring, and this is sometimes with a characteristic cribriform (criss-cross pattern) or atrophic appearance.

• #4 Pyoderma Gangrenosum – Skin Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/skin-disorders/hypersensitivity-and-reactive-skin-disorders/pyoderma-gangrenosum

  Pyoderma gangrenosum is a chronic inflammatory skin disorder of unknown cause that causes large sores on the skin. […] This disorder begins as small bumps or blisters that become open sores. […] Most often, pyoderma gangrenosum begins as a red bump that may resemble a pimple or an insect bite. Less often, it begins as a blister. The bump or blister then becomes an open, painful sore (ulcer) that expands rapidly. The sores have a raised border that is dusky or purple. The sores can grow together to form larger sores. People often are left with scars after sores heal. […] People commonly have fever and a general feeling of illness (malaise). […] Pyoderma gangrenosum can also develop at other locations, such as in the abdominal wall around a colostomy or ileostomy opening in people who have inflammatory bowel disease, or on the genitals or buttocks. In some people with pyoderma gangrenosum, areas other than the skin, such as the bones, lungs, heart, liver, or muscles, are affected. […] The diagnosis of pyoderma gangrenosum is strongly suggested if the sores worsen after minor trauma or a surgical procedure (such as a skin biopsy). […] Cyclosporine can be very effective, particularly for people whose disease is progressing rapidly.

• #5 Pyoderma Gangrenosum: Symptoms, Causes, and Treatment — DermNet

  https://dermnetnz.org/topics/pyoderma-gangrenosum

  Pyoderma gangrenosum (PG) presents as a rapidly enlarging, very painful ulcer. It is characterised by a full-thickness ulcer with blue/purple undermined borders and by pathergy. […] Pyoderma gangrenosum usually starts quite suddenly, often at the site of a minor injury. It may start as a small pustule, red bump, or blood-blister, often misinterpreted as an insect bite. The skin then breaks down resulting in an ulcer. The ulcer can deepen and widen rapidly. Characteristically, the edge of the ulcer is purple and undermined. Pyoderma gangrenosum is usually very painful. Several ulcers may develop at the same time or over months to years. […] Untreated, the ulcers may continue to enlarge, persist unchanged, or may slowly heal. Treatment is usually successful in arresting the process, but complete healing may take months. This is particularly true if there is an underlying venous disease, another reason for leg ulcers. Deep ulcers heal with scarring, and this is sometimes with a characteristic cribriform (criss-cross pattern) or atrophic appearance.

• #6 Pyoderma Gangrenosum – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/hypersensitivity-and-reactive-skin-disorders/pyoderma-gangrenosum

  Most often, pyoderma gangrenosum begins as an inflamed, erythematous papule, pustule, or nodule. The lesion, which may resemble a furuncle or an arthropod bite at this stage, ulcerates and expands rapidly, developing a swollen necrotic base and a raised dusky to violaceous border. An undermined border (ie, loss of underlying support tissue at the border) is common, if not pathognomonic. The ulcers can coalesce to form larger ulcers, often with cribriform or sieve-like scarring. […] Systemic symptoms such as fever and malaise are common. […] Symptoms and signs can vary with the subtype. […] In this most common subtype, ulcers form as described above, most commonly on the lower extremities or trunk, particularly the buttocks and perineum. […] This less common subtype often develops in patients with hematologic disorders. Lesions usually begin as bullae that erode, becoming superficial ulcers. The arms and face are most often involved.

• #7 Diagnosis and treatment of pyoderma gangrenosum

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1513476/

  Pyoderma gangrenosum is a rare but serious ulcerating skin disease, the treatment of which is mostly empirical. […] The mainstay of treatment is long term immunosuppression, often with high doses of corticosteroids or low doses of ciclosporin. […] Several variants exist, but the most common one is classic pyoderma gangrenosum. This presents as a deep ulcer with a well defined border, which is usually violet or blue. […] The ulcer often starts as a small papule or collection of papules, which break down to form small ulcers with a cat’s paw appearance. […] Patients are often systemically unwell with symptoms such as fever, malaise, arthralgia, and myalgia. […] Lesions are usually painful and the pain can be severe. […] Early diagnosis and prompt treatment reduce the risk of scars, and disfigurement may occur if the diagnosis is missed. […] Pyoderma usually develops rapidly and can progress from a pimple to a crater in 24-48 hours. […] Pyoderma is usually painful and patients may have systemic features such as fever.

• #8 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  Pyoderma gangrenosum (PG) is a reactive non-infectious inflammatory dermatosis falling under the spectrum of the neutrophilic dermatoses. This presents as an extremely painful erythematous lesion which rapidly progresses to a blistered or necrotic ulcer. There is often a ragged undermined edge with a violaceous/erythematous border. The lower legs are most frequently affected although PG can present at any body site. […] Classical PG presents most commonly as an extremely painful erythematous lesion which rapidly progresses to a blistered or necrotic ulcer. There is often a ragged undermined edge with a violaceous/erythematous border. The lesion may be precipitated by minor trauma, a phenomenon known as pathergy. […] Most cases of PG are of the classic ulcerative type (approximately 85%), but other subtypes include bullous, vegetative, pustular, peristomal and superficial granulomatous variants, with subtypes of PG sometimes transitioning from one form to another.

• #9 Pyoderma gangrenosum – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/symptoms-causes/syc-20350386

  Pyoderma gangrenosum can cause painful, open sores that have blue or purple edges. […] Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores on the skin. The sores can develop quickly. Most often they appear on the legs. […] Pyoderma gangrenosum usually starts with a small bump on the skin. It might look like a spider bite. Within days it can turn into a large and painful open sore. […] The sore usually appears on the legs but may develop anywhere on the body. Sometimes it appears around surgical sites. If you have two or more sores, they may grow and merge into one. […] Possible complications of pyoderma gangrenosum include infection, uncontrolled pain, scarring and and changes in skin color after the affected skin heals. This change in skin color is called postinflammatory hyperpigmentation when the skin darkens and postinflammatory hypopigmentation when the skin loses color. People with brown or Black skin have a higher risk of long-term skin color changes.

• #10 Pyoderma Gangrenosum – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/pyoderma-gangrenosum/

  Pyoderma gangrenosum (PG) is a rare, inflammatory, ulcerative disease. The clinical appearance of the ulceration is usually the first clue to this diagnosis. In the typical ulcerative PG form, the lesion starts as a pustule or nodule, which may have been provoked by a minor trauma (pathergy phenomenon). This lesion becomes ulcerated and slowly enlarges centrifugally, with a typical pattern: the periphery is elevated, erythematous or violaceous, and its inner part is undermined by purulent exudates. The center is an eroding ulcer, with a necrotic (gangrenous) appearance. Exposure of muscle or tendon may occur. Pain is variable, sometimes severe. The diameter of PG ulcers may reach 20 cm or more. PG ulcers are solitary or multiple. Any part of the body may be involved. […] In addition to the typical, classic ulcerative form, three additional PG clinical variants are recognized: bullous, pustular, and vegetative.

• #11 Pyoderma gangrenosum – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/symptoms-causes/syc-20350386

  Pyoderma gangrenosum can cause painful, open sores that have blue or purple edges. […] Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores on the skin. The sores can develop quickly. Most often they appear on the legs. […] Pyoderma gangrenosum usually starts with a small bump on the skin. It might look like a spider bite. Within days it can turn into a large and painful open sore. […] The sore usually appears on the legs but may develop anywhere on the body. Sometimes it appears around surgical sites. If you have two or more sores, they may grow and merge into one. […] Possible complications of pyoderma gangrenosum include infection, uncontrolled pain, scarring and and changes in skin color after the affected skin heals. This change in skin color is called postinflammatory hyperpigmentation when the skin darkens and postinflammatory hypopigmentation when the skin loses color. People with brown or Black skin have a higher risk of long-term skin color changes.

• #12 Pyoderma gangrenosum

  https://ask-ahd.ahdubai.com/con-20154762

  Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores (ulcers) to develop on your skin, most often on your legs. […] Pyoderma gangrenosum ulcers can develop quickly. They usually clear up with treatment, but scarring and recurrences are common. […] Pyoderma gangrenosum usually starts with a small, red bump on your skin, which may resemble a spider bite. Within days, this bump can develop into a large, painful open sore. […] The ulcer usually appears on your legs, but may develop anywhere on your body. Sometimes it appears around surgical sites. If you have several ulcers, they may grow and merge into one larger ulcer. […] Possible complications of pyoderma gangrenosum include infection, scarring, uncontrolled pain, depression and loss of mobility. […] Even after successful treatment, it’s common for new wounds to develop.

• #13 Pyoderma Gangrenosum: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17825-pyoderma-gangrenosum-pg

  Pyoderma gangrenosum commonly affects your lower extremities. It may also appear on your arms, genitals and neck. […] Symptoms of pyoderma gangrenosum include: Small, discolored (red, purple, blue, brown or black), pus-filled blisters that enlarge quickly. Open ulcers with distinct, raised borders. Inflammation and pain around your sores. Fever. Joint pain. […] Your ulcers may be large and deep, and they can be very painful. […] Pyoderma gangrenosum causes small, discolored bumps and inflammation on your skin. The bumps may be anywhere on your body, but they commonly appear on your lower extremities (legs, ankles and feet). […] The bumps often rapidly open up (erode) your skin and expand to large, painful ulcers. […] Pyoderma gangrenosum is difficult to treat. Even with proper treatment, it may take weeks or even months to heal.

• #14 Pyoderma Gangrenosum – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/hypersensitivity-and-reactive-skin-disorders/pyoderma-gangrenosum

  Most often, pyoderma gangrenosum begins as an inflamed, erythematous papule, pustule, or nodule. The lesion, which may resemble a furuncle or an arthropod bite at this stage, ulcerates and expands rapidly, developing a swollen necrotic base and a raised dusky to violaceous border. An undermined border (ie, loss of underlying support tissue at the border) is common, if not pathognomonic. The ulcers can coalesce to form larger ulcers, often with cribriform or sieve-like scarring. […] Systemic symptoms such as fever and malaise are common. […] Symptoms and signs can vary with the subtype. […] In this most common subtype, ulcers form as described above, most commonly on the lower extremities or trunk, particularly the buttocks and perineum. […] This less common subtype often develops in patients with hematologic disorders. Lesions usually begin as bullae that erode, becoming superficial ulcers. The arms and face are most often involved.

• #15 Clinicopathological features and prognosis of pyoderma gangrenosum in Korea: A single centre, retrospective, observational study over 20 years – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/clinicopathological-features-and-prognosis-of-pyoderma-gangrenosum-in-korea-a-single-center-retrospective-observational-study-over-20-years/

  Pyoderma gangrenosum is a rare autoinflammatory neutrophilic dermatosis that rapidly evolves. However, little is known about the clinicopathological features and prognosis of pyoderma gangrenosum. The most frequently affected area was the lower extremities (60.4%), followed by the head and neck (17.0%). The most common subtype was ulcerative (47.2%), followed by bullous (22.6%). Partial-to-complete remission was observed in 40 cases (75.5%). Nine (17.0%) cases experienced recurrence with a median progression-free period of six months (interquartile range of 3.0-9.0 months). Cases with underlying hematologic disorders and the bullous subtype were significantly associated with early recurrence. Pyoderma gangrenosum appears to have ethnic differences. Underlying haematologic disorders and bullous subtype have a worse prognosis. However, the type of histopathology did not correlate with the clinical outcome of pyoderma gangrenosum.

• #16 Causes, Symptoms & Treatment of Pyoderma Gangrenosum

  https://legsmatter.org/information-and-support/skin-concerns/pyoderma-gangrenosum/

  The condition usually starts with one single ulcer; this can unfortunately deteriorate quite quickly to a large or deep wound. […] Pain or discomfort from the ulcer is common from the outset. […] Pyoderma Gangrenosum can be difficult to treat and this is similar to all inflammatory conditions. Sometimes it can take a while to establish which medication is more effective. […] Once the inflammation is under control, the pain will reduce and healing will be seen. […] If there is significant lower leg swelling, the use of compression therapy is critical and sometimes consistent healing will not be seen until this is used.

• #17 The challenges of managing patients with pyoderma gangrenosum: three case reports :: Cambridge Media Journals

  https://journals.cambridgemedia.com.au/wpr/volume-24-no-1/challenges-managing-patients-pyoderma-gangrenosum-three-case-reports

  Pyoderma gangrenosum (PG) is an atypical neutrophilic dermatosis that appears as an inflammatory and ulcerative condition of the skin. Brunstig et al. describe the ulcers as enlarging, painful, necrotic with bluish edges and circumferential erythema. Characteristically, the lesions begin as a small nodule or sterile pustule which enlarge into well-demarcated ulcers, which can extend to the fascia with violaceous margins (red-blue) undermined border, surrounding erythema and induration. Typically the lesions have necrosis at the base, friable granulation tissue with a purulent or haemoserous exudate. The ulcers are often described as necrolytic, a process whereby as the tissue is destroyed, the liquefactive necrosis reveals a red-blue undermined wound edge. Invariably the lesions are extremely painful. Atrophic cribriform pigmented scarring can occur as the lesions heal, particularly with delayed diagnosis and treatment. PG has also been described in association with pathergy, a process that occurs as a result of trauma. This has been reported in wounds ranging from minor trauma to surgical incision sites. In a retrospective review of 103 patients, pathergy was documented in 31% of patients.

• #18 Pyoderma gangrenosum – Wikipedia

  https://en.wikipedia.org/wiki/Pyoderma_gangrenosum

  Pyoderma gangrenosum is a rare, inflammatory skin disease where painful pustules or nodules become ulcers that progressively grow. […] The disease was identified in 1930. It affects approximately 1 person in 100,000 in the population. Though it can affect people of any age, it mostly affects people in their 40s and 50s. […] One hallmark of pyoderma gangrenosum is pathergy, which is the appearance of new lesions at sites of trauma, including surgical wounds. […] Diagnosis of PG is challenging owing to its variable presentation, clinical overlap with other conditions, association with several systemic diseases, and absence of defining histopathologic or laboratory findings. Misdiagnosis and delayed diagnosis are common. It has been shown that up to 39% of patients who initially received a diagnosis of PG have an alternative diagnosis. […] First-line therapy for disseminated or localized instances of pyoderma gangrenosum is systemic treatment with corticosteroids and ciclosporin.

• #19 Pyoderma Gangrenosum: Background, Epidemiology, Prognosis

  https://emedicine.medscape.com/article/1123821-overview

  Pyoderma gangrenosum is an uncommon ulcerative cutaneous condition whose cause is uncertain. Although the etiology of this condition is poorly understood, dysregulation of the immune system (specifically, altered neutrophil chemotaxis) is believed to be involved. Pyoderma gangrenosum is associated with systemic diseases in at least 50% of patients who are affected. […] The diagnosis is made by excluding other causes of similar-appearing cutaneous ulcerations, including infection, malignancy, vasculitis, vasculopathy, venous insufficiency, collagen-vascular diseases, diabetes, and trauma. In a process termed pathergy, new ulcerations may occur after trauma or injury to the skin in 30% of patients who already have pyoderma gangrenosum. […] Patients with pyoderma gangrenosum may have involvement of other organ systems that manifests as sterile neutrophilic infiltrates. Culture-negative pulmonary infiltrates are the most common extracutaneous manifestation. Other organ systems that may be involved include the heart, the central nervous system (CNS), the gastrointestinal (GI) tract, the eyes, the liver, the spleen, the bones, and the lymph nodes.

• #20 Pyoderma Gangrenosum: Symptoms, Causes, and Treatment — DermNet

  https://dermnetnz.org/topics/pyoderma-gangrenosum

  Pyoderma gangrenosum (PG) presents as a rapidly enlarging, very painful ulcer. It is characterised by a full-thickness ulcer with blue/purple undermined borders and by pathergy. […] Pyoderma gangrenosum usually starts quite suddenly, often at the site of a minor injury. It may start as a small pustule, red bump, or blood-blister, often misinterpreted as an insect bite. The skin then breaks down resulting in an ulcer. The ulcer can deepen and widen rapidly. Characteristically, the edge of the ulcer is purple and undermined. Pyoderma gangrenosum is usually very painful. Several ulcers may develop at the same time or over months to years. […] Untreated, the ulcers may continue to enlarge, persist unchanged, or may slowly heal. Treatment is usually successful in arresting the process, but complete healing may take months. This is particularly true if there is an underlying venous disease, another reason for leg ulcers. Deep ulcers heal with scarring, and this is sometimes with a characteristic cribriform (criss-cross pattern) or atrophic appearance.

• #21 Diagnosis and treatment of pyoderma gangrenosum

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1513476/

  Pyoderma gangrenosum is a rare but serious ulcerating skin disease, the treatment of which is mostly empirical. […] The mainstay of treatment is long term immunosuppression, often with high doses of corticosteroids or low doses of ciclosporin. […] Several variants exist, but the most common one is classic pyoderma gangrenosum. This presents as a deep ulcer with a well defined border, which is usually violet or blue. […] The ulcer often starts as a small papule or collection of papules, which break down to form small ulcers with a cat’s paw appearance. […] Patients are often systemically unwell with symptoms such as fever, malaise, arthralgia, and myalgia. […] Lesions are usually painful and the pain can be severe. […] Early diagnosis and prompt treatment reduce the risk of scars, and disfigurement may occur if the diagnosis is missed. […] Pyoderma usually develops rapidly and can progress from a pimple to a crater in 24-48 hours. […] Pyoderma is usually painful and patients may have systemic features such as fever.

• #22 Is Pyoderma Gangrenosum Caused By Ulcerative Colitis?

  https://www.healthline.com/health/ulcerative-colitis/pyoderma-gangrenosum-ulcerative-colitis

  These sores are often very painful. They may spread and become wider as well as deeper. […] Doctors may classify pyoderma gangrenosum lesions by their appearance. […] Classic pyoderma gangrenosum often appears near surgical openings, such as a stoma for stool to exit. […] Those with inflammatory bowel diseases, such as ulcerative colitis, are most likely to experience pustular pyoderma gangrenosum. This condition causes painful, pus-filled bumps to form. […] Treating pyoderma gangrenosum involves addressing the lesions to keep infection at bay, reduce discomfort, and keep the lesions from spreading or enlarging. […] Pyoderma gangrenosum can also cause significant pain. […] While sometimes painful, pyoderma gangrenosum isnt known to be life threatening.

• #23 Pyoderma gangrenosum

  https://www.nhs.uk/conditions/pyoderma-gangrenosum/

  Pyoderma gangrenosum is a rare skin condition that causes large, painful ulcers. […] The main symptom of pyoderma gangrenosum is a large, painful ulcer on your skin. It usually starts as a small bump, spot or blood blister that gets bigger quickly and turns into an ulcer. Sometimes you may have more than 1 ulcer. […] Pyoderma gangrenosum ulcers usually appear on the legs or chest. They may also appear around a cut or graze, a stoma, or cuts from surgery. They may leak fluid. […] Other symptoms include stiff joints, aching and painful muscles, and a high temperature. […] It can take a long time for the ulcers to heal and you may have scars.

• #24 Diagnosis and treatment of pyoderma gangrenosum

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1513476/

  Pyoderma gangrenosum is a rare but serious ulcerating skin disease, the treatment of which is mostly empirical. […] The mainstay of treatment is long term immunosuppression, often with high doses of corticosteroids or low doses of ciclosporin. […] Several variants exist, but the most common one is classic pyoderma gangrenosum. This presents as a deep ulcer with a well defined border, which is usually violet or blue. […] The ulcer often starts as a small papule or collection of papules, which break down to form small ulcers with a cat’s paw appearance. […] Patients are often systemically unwell with symptoms such as fever, malaise, arthralgia, and myalgia. […] Lesions are usually painful and the pain can be severe. […] Early diagnosis and prompt treatment reduce the risk of scars, and disfigurement may occur if the diagnosis is missed. […] Pyoderma usually develops rapidly and can progress from a pimple to a crater in 24-48 hours. […] Pyoderma is usually painful and patients may have systemic features such as fever.

• #25 Pyoderma Gangrenosum With Systemic Symptoms Initially Misdiagnosed as Cellulitis | Consultant360

  https://www.consultant360.com/article/consultant360/pyoderma-gangrenosum-systemic-symptoms-initially-misdiagnosed-cellulitis

  A 67-year-old woman with a history of irritable bowel syndrome (IBS) and diverticulitis presented to her primary care provider for evaluation of a leg wound. Over the course of a few days, the patient had developed warmth, erythema, edema, pain, and tenderness of the left anterior lower leg. […] On consultation, the patient reported having low-grade fevers, joint pain in her elbows and shoulders, and extreme pain of the involved left lower leg. […] Three days later, the patient developed worsening painful violaceous ulceration with undermined borders on the left shin and inferior abdomen, and new tender violaceous nodules and plaques on the dorsal left foot, right lower leg, and bilateral arms. […] The skin lesions continued to worsen despite the administration of broad-spectrum intravenous antibiotics, and the patients interdisciplinary team agreed on a final clinical diagnosis of PG with systemic symptoms.

• #26 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  Pyoderma gangrenosum (PG) is a reactive non-infectious inflammatory dermatosis falling under the spectrum of the neutrophilic dermatoses. This presents as an extremely painful erythematous lesion which rapidly progresses to a blistered or necrotic ulcer. There is often a ragged undermined edge with a violaceous/erythematous border. The lower legs are most frequently affected although PG can present at any body site. […] Classical PG presents most commonly as an extremely painful erythematous lesion which rapidly progresses to a blistered or necrotic ulcer. There is often a ragged undermined edge with a violaceous/erythematous border. The lesion may be precipitated by minor trauma, a phenomenon known as pathergy. […] Most cases of PG are of the classic ulcerative type (approximately 85%), but other subtypes include bullous, vegetative, pustular, peristomal and superficial granulomatous variants, with subtypes of PG sometimes transitioning from one form to another.

• #27 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  The most common form of PG presents as a rapidly progressive painful ulcer with a violaceous undermined edge. […] This form presents with rapidly evolving painful superficial vesicles and bullae arising in waves, often coalescing together most commonly on the arms. […] This form is most commonly seen in the context of flaring inflammatory bowel disease and presents with painful pustules on a background of erythema, often on the extensor surfaces. […] Granulomatous superficial PG, otherwise known as vegetative PG, usually progresses more slowly and presents with verrucous and ulcerative lesions. […] This variant probably results from a pathergic response to trauma from faecal irritation or secondary to appliances on the skin and is most frequently seen in the context of stomas in patients with inflammatory bowel disease.

• #28 Pyoderma Gangrenosum: Symptoms and Treatment | Doctor

  https://patient.info/doctor/pyoderma-gangrenosum-pro

  Pyoderma gangrenosum symptoms (presentation) […] PG can present in various ways and there are several different forms (listed below). It is not always easy to recognise, although early recognition and treatment are important. […] Consider PG in any non-healing ulcer or wound. […] Lesions can progress rapidly, from pimple to crater within 48 hours. […] Classical PG […] This is the most common type. […] This begins as pustule(s) or nodule(s); these soon break down to form a rapidly enlarging ulcer, which has a raised inflammatory border and a boggy, necrotic base. The base may be studded with small abscesses. The ulcer is usually painful and the pain may be severe. It heals with scarring. […] The ulcers are most common on the lower legs and trunk. […] Pathergy (ulcers in the site of minor trauma) is common. […] The clinical course may follow two patterns: […] Explosive onset and rapid spread of lesions, with pain, systemic illness and fever. […] Indolent and slow-spreading, with spontaneous regression and healing in one area and progression in another.

• #29 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  Pyoderma gangrenosum (PG) is a reactive non-infectious inflammatory dermatosis falling under the spectrum of the neutrophilic dermatoses. This presents as an extremely painful erythematous lesion which rapidly progresses to a blistered or necrotic ulcer. There is often a ragged undermined edge with a violaceous/erythematous border. The lower legs are most frequently affected although PG can present at any body site. […] Classical PG presents most commonly as an extremely painful erythematous lesion which rapidly progresses to a blistered or necrotic ulcer. There is often a ragged undermined edge with a violaceous/erythematous border. The lesion may be precipitated by minor trauma, a phenomenon known as pathergy. […] Most cases of PG are of the classic ulcerative type (approximately 85%), but other subtypes include bullous, vegetative, pustular, peristomal and superficial granulomatous variants, with subtypes of PG sometimes transitioning from one form to another.

• #30 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  The most common form of PG presents as a rapidly progressive painful ulcer with a violaceous undermined edge. […] This form presents with rapidly evolving painful superficial vesicles and bullae arising in waves, often coalescing together most commonly on the arms. […] This form is most commonly seen in the context of flaring inflammatory bowel disease and presents with painful pustules on a background of erythema, often on the extensor surfaces. […] Granulomatous superficial PG, otherwise known as vegetative PG, usually progresses more slowly and presents with verrucous and ulcerative lesions. […] This variant probably results from a pathergic response to trauma from faecal irritation or secondary to appliances on the skin and is most frequently seen in the context of stomas in patients with inflammatory bowel disease.

• #31 Pyoderma Gangrenosum – Dermatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.856.5.

  Pyoderma gangrenosum (PG) is a neutrophilic ulcerative dermatosis with a spectrum of clinical presentations and variable clinical course. PG commonly affects women aged 20 to 50 years and occurs on the lower extremities, but it can involve any area of the body, including the head and neck in children and the genital and perianal areas in infants. Lesions are usually limited to 1 to 3, with 5% of body surface area (BSA) involved. The course of PG can be indolent, aggressive, or fulminant. PG often demonstrates a chronic, relapsing course. Worsening or development of new lesions after a trauma (known as pathergy) is a common characteristic of active PG. […] Classic ulcerative PG: It is the most common PG variant that most frequently affects the legs. It is characterized by a rapidly progressing painful wound with a peripheral red halo and raised red-purple undermined edges. Systemic symptoms are common in classic ulcerative PG, including fever, malaise, arthralgia, and myalgia. The lung is the most common extracutaneous organ involved in patients with PG. Pulmonary involvement may range from asymptomatic presentation to severe respiratory distress.

• #32 Pyoderma Gangrenosum: Symptoms and Treatment | Doctor

  https://patient.info/doctor/pyoderma-gangrenosum-pro

  Pyoderma gangrenosum symptoms (presentation) […] PG can present in various ways and there are several different forms (listed below). It is not always easy to recognise, although early recognition and treatment are important. […] Consider PG in any non-healing ulcer or wound. […] Lesions can progress rapidly, from pimple to crater within 48 hours. […] Classical PG […] This is the most common type. […] This begins as pustule(s) or nodule(s); these soon break down to form a rapidly enlarging ulcer, which has a raised inflammatory border and a boggy, necrotic base. The base may be studded with small abscesses. The ulcer is usually painful and the pain may be severe. It heals with scarring. […] The ulcers are most common on the lower legs and trunk. […] Pathergy (ulcers in the site of minor trauma) is common. […] The clinical course may follow two patterns: […] Explosive onset and rapid spread of lesions, with pain, systemic illness and fever. […] Indolent and slow-spreading, with spontaneous regression and healing in one area and progression in another.

• #33 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  The most common form of PG presents as a rapidly progressive painful ulcer with a violaceous undermined edge. […] This form presents with rapidly evolving painful superficial vesicles and bullae arising in waves, often coalescing together most commonly on the arms. […] This form is most commonly seen in the context of flaring inflammatory bowel disease and presents with painful pustules on a background of erythema, often on the extensor surfaces. […] Granulomatous superficial PG, otherwise known as vegetative PG, usually progresses more slowly and presents with verrucous and ulcerative lesions. […] This variant probably results from a pathergic response to trauma from faecal irritation or secondary to appliances on the skin and is most frequently seen in the context of stomas in patients with inflammatory bowel disease.

• #34 Pyoderma Gangrenosum – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/hypersensitivity-and-reactive-skin-disorders/pyoderma-gangrenosum

  Most often, pyoderma gangrenosum begins as an inflamed, erythematous papule, pustule, or nodule. The lesion, which may resemble a furuncle or an arthropod bite at this stage, ulcerates and expands rapidly, developing a swollen necrotic base and a raised dusky to violaceous border. An undermined border (ie, loss of underlying support tissue at the border) is common, if not pathognomonic. The ulcers can coalesce to form larger ulcers, often with cribriform or sieve-like scarring. […] Systemic symptoms such as fever and malaise are common. […] Symptoms and signs can vary with the subtype. […] In this most common subtype, ulcers form as described above, most commonly on the lower extremities or trunk, particularly the buttocks and perineum. […] This less common subtype often develops in patients with hematologic disorders. Lesions usually begin as bullae that erode, becoming superficial ulcers. The arms and face are most often involved.

• #35 Pyoderma Gangrenosum – Dermatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.856.5.

  The average time between surgery and onset of symptoms of postsurgical PG is 11 days; the risk of postsurgical recurrence in future surgeries of a person with PG is 15%. […] Pustular PG is a rare, superficial PG variant beginning as a sterile inflammatory pustule or a group of sterile pustules that coalesce and ulcerate to the pustular stage with a red halo. These ulcers are painful and can regress without scarring or persist for months and evolve into classic PG. […] Bullous PG is a rare PG variant that predominantly occurs on the upper limbs, face, dorsum of the hands, or extensor surfaces of the arms. Bullous PG has a poor prognosis due to its association with hematologic conditions and malignancies such as acute myelogenous leukemia. […] Systemic symptoms are common in classic ulcerative PG, including fever, malaise, arthralgia, and myalgia. The lung is the most common extracutaneous organ involved in patients with PG. Pulmonary involvement may range from asymptomatic presentation to severe respiratory distress.

• #36 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  The most common form of PG presents as a rapidly progressive painful ulcer with a violaceous undermined edge. […] This form presents with rapidly evolving painful superficial vesicles and bullae arising in waves, often coalescing together most commonly on the arms. […] This form is most commonly seen in the context of flaring inflammatory bowel disease and presents with painful pustules on a background of erythema, often on the extensor surfaces. […] Granulomatous superficial PG, otherwise known as vegetative PG, usually progresses more slowly and presents with verrucous and ulcerative lesions. […] This variant probably results from a pathergic response to trauma from faecal irritation or secondary to appliances on the skin and is most frequently seen in the context of stomas in patients with inflammatory bowel disease.

• #37 Pyoderma Gangrenosum: Symptoms and Treatment | Doctor

  https://patient.info/doctor/pyoderma-gangrenosum-pro

  Peristomal PG […] PG can occur in skin around stoma sites. […] This is particularly common in IBD patients. […] Around 15% of all cases of PG. […] Vegetative PG […] This is usually a single lesion in healthy patients; it is a less aggressive form than classical PG. Often there is no systemic disease. It may respond well to topical treatment. […] Lesions are mainly on the head and neck. […] The ulceration is more superficial than classical PG; the ulcer base is usually non-purulent, and there are no undermined borders or surrounding erythema. […] Bullous PG […] Presents with concentric, painful bullous areas, rapidly spreading. These break down to form ulcers, which are more superficial than in classical PG. It affects the face and upper limbs more than the legs. […] It has been reported in association with haematological disease.

• #38 Pyoderma Gangrenosum – Dermatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.856.5.

  The average time between surgery and onset of symptoms of postsurgical PG is 11 days; the risk of postsurgical recurrence in future surgeries of a person with PG is 15%. […] Pustular PG is a rare, superficial PG variant beginning as a sterile inflammatory pustule or a group of sterile pustules that coalesce and ulcerate to the pustular stage with a red halo. These ulcers are painful and can regress without scarring or persist for months and evolve into classic PG. […] Bullous PG is a rare PG variant that predominantly occurs on the upper limbs, face, dorsum of the hands, or extensor surfaces of the arms. Bullous PG has a poor prognosis due to its association with hematologic conditions and malignancies such as acute myelogenous leukemia. […] Systemic symptoms are common in classic ulcerative PG, including fever, malaise, arthralgia, and myalgia. The lung is the most common extracutaneous organ involved in patients with PG. Pulmonary involvement may range from asymptomatic presentation to severe respiratory distress.

• #39 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  The most common form of PG presents as a rapidly progressive painful ulcer with a violaceous undermined edge. […] This form presents with rapidly evolving painful superficial vesicles and bullae arising in waves, often coalescing together most commonly on the arms. […] This form is most commonly seen in the context of flaring inflammatory bowel disease and presents with painful pustules on a background of erythema, often on the extensor surfaces. […] Granulomatous superficial PG, otherwise known as vegetative PG, usually progresses more slowly and presents with verrucous and ulcerative lesions. […] This variant probably results from a pathergic response to trauma from faecal irritation or secondary to appliances on the skin and is most frequently seen in the context of stomas in patients with inflammatory bowel disease.

• #40 Pyoderma Gangrenosum: Symptoms and Treatment | Doctor

  https://patient.info/doctor/pyoderma-gangrenosum-pro

  Peristomal PG […] PG can occur in skin around stoma sites. […] This is particularly common in IBD patients. […] Around 15% of all cases of PG. […] Vegetative PG […] This is usually a single lesion in healthy patients; it is a less aggressive form than classical PG. Often there is no systemic disease. It may respond well to topical treatment. […] Lesions are mainly on the head and neck. […] The ulceration is more superficial than classical PG; the ulcer base is usually non-purulent, and there are no undermined borders or surrounding erythema. […] Bullous PG […] Presents with concentric, painful bullous areas, rapidly spreading. These break down to form ulcers, which are more superficial than in classical PG. It affects the face and upper limbs more than the legs. […] It has been reported in association with haematological disease.

• #41 Pyoderma Gangrenosum – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/hypersensitivity-and-reactive-skin-disorders/pyoderma-gangrenosum

  This subtype tends to develop during exacerbations of inflammatory bowel disease. Painful pustules develop, surrounded by erythema. Arthralgias are common. […] In this subtype, a single, indolent, mildly painful plaque or superficial ulcer develops, most often on the head or neck. The border is not undermined and the base is not necrotic. […] Pyoderma gangrenosum can also develop at other sites, such as around a stoma in patients who have inflammatory bowel disease (peristomal pyoderma gangrenosum), on the genitals (genital pyoderma gangrenosum), or in sites other than the skin, such as the bones, cornea, central nervous system, heart, intestine, liver, lungs, or muscle (extracutaneous pyoderma gangrenosum).

• #42 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  The most common form of PG presents as a rapidly progressive painful ulcer with a violaceous undermined edge. […] This form presents with rapidly evolving painful superficial vesicles and bullae arising in waves, often coalescing together most commonly on the arms. […] This form is most commonly seen in the context of flaring inflammatory bowel disease and presents with painful pustules on a background of erythema, often on the extensor surfaces. […] Granulomatous superficial PG, otherwise known as vegetative PG, usually progresses more slowly and presents with verrucous and ulcerative lesions. […] This variant probably results from a pathergic response to trauma from faecal irritation or secondary to appliances on the skin and is most frequently seen in the context of stomas in patients with inflammatory bowel disease.

• #43 Pyoderma Gangrenosum – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/hypersensitivity-and-reactive-skin-disorders/pyoderma-gangrenosum

  This subtype tends to develop during exacerbations of inflammatory bowel disease. Painful pustules develop, surrounded by erythema. Arthralgias are common. […] In this subtype, a single, indolent, mildly painful plaque or superficial ulcer develops, most often on the head or neck. The border is not undermined and the base is not necrotic. […] Pyoderma gangrenosum can also develop at other sites, such as around a stoma in patients who have inflammatory bowel disease (peristomal pyoderma gangrenosum), on the genitals (genital pyoderma gangrenosum), or in sites other than the skin, such as the bones, cornea, central nervous system, heart, intestine, liver, lungs, or muscle (extracutaneous pyoderma gangrenosum).

• #44 Pyoderma Gangrenosum: Symptoms, Causes, and Treatment — DermNet

  https://dermnetnz.org/topics/pyoderma-gangrenosum

  Pyoderma gangrenosum (PG) presents as a rapidly enlarging, very painful ulcer. It is characterised by a full-thickness ulcer with blue/purple undermined borders and by pathergy. […] Pyoderma gangrenosum usually starts quite suddenly, often at the site of a minor injury. It may start as a small pustule, red bump, or blood-blister, often misinterpreted as an insect bite. The skin then breaks down resulting in an ulcer. The ulcer can deepen and widen rapidly. Characteristically, the edge of the ulcer is purple and undermined. Pyoderma gangrenosum is usually very painful. Several ulcers may develop at the same time or over months to years. […] Untreated, the ulcers may continue to enlarge, persist unchanged, or may slowly heal. Treatment is usually successful in arresting the process, but complete healing may take months. This is particularly true if there is an underlying venous disease, another reason for leg ulcers. Deep ulcers heal with scarring, and this is sometimes with a characteristic cribriform (criss-cross pattern) or atrophic appearance.

• #45 Orphanet: Pyoderma gangrenosum

  https://www.orpha.net/en/disease/detail/48104

  A rare inflammatory neutrophilic dermatosis characterized by painful cutaneous ulcerations with a violaceous and undermined border affecting the lower extremities; however, any hair-bearing area can be affected. […] Clinically, onset occurs with pustules, nodules, or ulcers on the lower extremity with a violaceous, undermined border. Ulcers are primarily sterile but may be complicated by secondary microbial colonization. They can rapidly progress and turn into very painful ulcers of variable depth and size. […] The clinical course is unpredictable; it can be mild or severe, chronic, or relapsing with significant morbidity; some patients might heal spontaneously. […] Despite recent advances in therapy, the prognosis of PG remains unpredictable. Recurrence rates have been reported in up to 30% of patients. Patients carry an increased mortality rate, three times higher than that of the general population, which may be due to associated conditions rather than PG itself though this remains to be elucidated.

• #46 Diagnosis and treatment of pyoderma gangrenosum

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1513476/

  Pyoderma gangrenosum is a rare but serious ulcerating skin disease, the treatment of which is mostly empirical. […] The mainstay of treatment is long term immunosuppression, often with high doses of corticosteroids or low doses of ciclosporin. […] Several variants exist, but the most common one is classic pyoderma gangrenosum. This presents as a deep ulcer with a well defined border, which is usually violet or blue. […] The ulcer often starts as a small papule or collection of papules, which break down to form small ulcers with a cat’s paw appearance. […] Patients are often systemically unwell with symptoms such as fever, malaise, arthralgia, and myalgia. […] Lesions are usually painful and the pain can be severe. […] Early diagnosis and prompt treatment reduce the risk of scars, and disfigurement may occur if the diagnosis is missed. […] Pyoderma usually develops rapidly and can progress from a pimple to a crater in 24-48 hours. […] Pyoderma is usually painful and patients may have systemic features such as fever.

• #47 Pyoderma Gangrenosum: Symptoms and Treatment | Doctor

  https://patient.info/doctor/pyoderma-gangrenosum-pro

  Pyoderma gangrenosum symptoms (presentation) […] PG can present in various ways and there are several different forms (listed below). It is not always easy to recognise, although early recognition and treatment are important. […] Consider PG in any non-healing ulcer or wound. […] Lesions can progress rapidly, from pimple to crater within 48 hours. […] Classical PG […] This is the most common type. […] This begins as pustule(s) or nodule(s); these soon break down to form a rapidly enlarging ulcer, which has a raised inflammatory border and a boggy, necrotic base. The base may be studded with small abscesses. The ulcer is usually painful and the pain may be severe. It heals with scarring. […] The ulcers are most common on the lower legs and trunk. […] Pathergy (ulcers in the site of minor trauma) is common. […] The clinical course may follow two patterns: […] Explosive onset and rapid spread of lesions, with pain, systemic illness and fever. […] Indolent and slow-spreading, with spontaneous regression and healing in one area and progression in another.

• #48 Pyoderma Gangrenosum: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17825-pyoderma-gangrenosum-pg

  Pyoderma gangrenosum commonly affects your lower extremities. It may also appear on your arms, genitals and neck. […] Symptoms of pyoderma gangrenosum include: Small, discolored (red, purple, blue, brown or black), pus-filled blisters that enlarge quickly. Open ulcers with distinct, raised borders. Inflammation and pain around your sores. Fever. Joint pain. […] Your ulcers may be large and deep, and they can be very painful. […] Pyoderma gangrenosum causes small, discolored bumps and inflammation on your skin. The bumps may be anywhere on your body, but they commonly appear on your lower extremities (legs, ankles and feet). […] The bumps often rapidly open up (erode) your skin and expand to large, painful ulcers. […] Pyoderma gangrenosum is difficult to treat. Even with proper treatment, it may take weeks or even months to heal.

• #49 Pyoderma gangrenosum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/diagnosis-treatment/drc-20350392

  Your healthcare professional will talk with you about your symptoms and medical history and conduct a physical exam. […] No test can confirm a diagnosis of pyoderma gangrenosum. But you may need tests to rule out other conditions that have similar symptoms. […] Treatment of pyoderma gangrenosum is aimed at reducing swelling, controlling pain and helping skin sores heal. […] Some people respond well to treatment with a combination of medicine taken by mouth, creams and injections. […] Sores can take weeks or months to heal, and it’s common for new ones to develop. […] Because pyoderma gangrenosum can be made worse by cuts to the skin, surgery to remove dead tissue is not usually considered a good treatment option. […] If sores are large and aren’t healing, a skin graft may be an option. […] With treatment you’re likely to recover from pyoderma gangrenosum. It may take a long time and you may feel stressed about whether new sores will form.

• #50 Pyoderma gangrenosum – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/pyoderma-gangrenosum/

  Pyoderma gangrenosum is a rare treatable cause of skin ulceration. […] The appearance of the condition may vary. It may start as a small pimple, red bump, pustule or blood-blister. The skin usually breaks down to form an ulcer which often oozes fluid. The ulcer can enlarge rapidly. […] There is usually a single large ulcer. Occasionally there may be multiple ulcers. Ulcers may become infected, oozing fluid or pus. Pain or discomfort from the ulcer is common. […] Pyoderma gangrenosum is often difficult to treat and may take some time to heal. More than one treatment may need to be tried. Skin grafts and surgery are not treatment options as they often fail and may cause enlargement of the ulcer.

• #51 Pyoderma gangrenosum – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/symptoms-causes/syc-20350386

  Pyoderma gangrenosum can cause painful, open sores that have blue or purple edges. […] Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores on the skin. The sores can develop quickly. Most often they appear on the legs. […] Pyoderma gangrenosum usually starts with a small bump on the skin. It might look like a spider bite. Within days it can turn into a large and painful open sore. […] The sore usually appears on the legs but may develop anywhere on the body. Sometimes it appears around surgical sites. If you have two or more sores, they may grow and merge into one. […] Possible complications of pyoderma gangrenosum include infection, uncontrolled pain, scarring and and changes in skin color after the affected skin heals. This change in skin color is called postinflammatory hyperpigmentation when the skin darkens and postinflammatory hypopigmentation when the skin loses color. People with brown or Black skin have a higher risk of long-term skin color changes.

• #52 Pyoderma gangrenosum – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/pyoderma-gangrenosum/

  Pyoderma gangrenosum usually occurs in young to middle-aged adults. The appearance of the condition may vary. It may start as a small pimple, red bump, pustule or blood-blister. The skin usually breaks down to form an ulcer which often oozes fluid. The ulcer can enlarge rapidly. The edge of the ulcer may look purplish. Once the ulcer has healed, the resulting scar may be darker than the surrounding skin (hyperpigmented), pale, thin and wrinkled in appearance or pitted. […] There is usually a single large ulcer. Occasionally there may be multiple ulcers. Ulcers may become infected, oozing fluid or pus. Pain or discomfort from the ulcer is common. Pyoderma gangrenosum is not a skin cancer and does not lead to cancer.

• #53 Pyoderma Gangrenosum: Background, Epidemiology, Prognosis

  https://emedicine.medscape.com/article/1123821-overview

  The prognosis for patients with pyoderma gangrenosum is generally good; however, the disease may recur, and residual scarring is common. One study reported that 16% of their 103 patients died during the 8-year study period. Pain is a common patient complaint and may require pain medication for control. […] Most patients with pyoderma gangrenosum improve with initial immunosuppressive therapy and require minimal care afterwards. However, many patients follow a refractory course, and multiple therapies may fail. These patients pose a difficult clinical problem that necessitates frequent follow-up and long-term care. […] Some patients demonstrate pathergy, or the development of pyoderma gangrenosumlike lesions at the site of skin trauma; in such instances, protection of the skin from trauma may prevent a recurrence of the disease. Pathergy may create problems with wound healing, especially after surgical procedures (eg, breast reconstruction or grafting). […] Death from pyoderma gangrenosum is rare, but it may occur as a consequence of an associated disease or as a result of therapy.

• #54 Pyoderma Gangrenosum – Dermatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.856.5.

  Factors associated with poor prognosis include increased disease severity; older age at diagnosis; ulcerative and bullous variants; and underlying disease, superinfection, and sepsis unresponsive to treatment. Ulcer recurrence occurs in 70% of patients treated with prednisolone and in 66% of those treated with cyclosporine. Ultimately, despite advances in PG treatment, the prognosis is unpredictable due to the chronic, relapsing nature of PG and its complications with a mortality rate of up to 30%.

• #55 Pyoderma Gangrenosum Treatment: Top Management Strategies | Maggie Yu MD, IFMCP

  https://drmaggieyu.com/blog/pyoderma-gangrenosum-treatment-top-management-strategies/

  Recurrence is a concern for those with pyoderma gangrenosum. Even after successful treatment, the condition can return. The risk of recurrence varies among individuals. Some experience multiple flare-ups, while others remain symptom-free for years. […] Living with a chronic condition like pyoderma gangrenosum can be challenging emotionally. Joining support groups provides emotional relief and practical advice from others facing similar issues.

• #56 Pyoderma Gangrenosum – Dermatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.856.5.

  The average time between surgery and onset of symptoms of postsurgical PG is 11 days; the risk of postsurgical recurrence in future surgeries of a person with PG is 15%. […] Pustular PG is a rare, superficial PG variant beginning as a sterile inflammatory pustule or a group of sterile pustules that coalesce and ulcerate to the pustular stage with a red halo. These ulcers are painful and can regress without scarring or persist for months and evolve into classic PG. […] Bullous PG is a rare PG variant that predominantly occurs on the upper limbs, face, dorsum of the hands, or extensor surfaces of the arms. Bullous PG has a poor prognosis due to its association with hematologic conditions and malignancies such as acute myelogenous leukemia. […] Systemic symptoms are common in classic ulcerative PG, including fever, malaise, arthralgia, and myalgia. The lung is the most common extracutaneous organ involved in patients with PG. Pulmonary involvement may range from asymptomatic presentation to severe respiratory distress.

• #57 Pyoderma Gangrenosum – Dermatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.856.5.

  Factors associated with poor prognosis include increased disease severity; older age at diagnosis; ulcerative and bullous variants; and underlying disease, superinfection, and sepsis unresponsive to treatment. Ulcer recurrence occurs in 70% of patients treated with prednisolone and in 66% of those treated with cyclosporine. Ultimately, despite advances in PG treatment, the prognosis is unpredictable due to the chronic, relapsing nature of PG and its complications with a mortality rate of up to 30%.

• #58 Pyoderma Gangrenosum: Symptoms, Causes, Treatment

  https://www.verywellhealth.com/pyoderma-gangrenosum-8364747

  Pyoderma gangrenosum (PG) is a rare, chronic skin condition that causes a painful rash leading to ulcers or open sores. Initially, the rash may look like a blood pimple or a blood blister that wont go away. Over time, skin around the blister deteriorates, leaving an open wound. […] The most prominent symptom of pyoderma gangrenosum is open ulcers filled with fibrinous debris. People with atypical pyoderma gangrenosum might not develop these ulcers. These ulcers usually start with a small rash that spreads quickly. The ulcers might continue spreading or heal on their own. […] In addition to ulcers, other symptoms of pyoderma gangrenosum include fever, localized pain around the rash and ulcers, feeling generally unwell, and joint pain. […] Pyoderma gangrenosum is a serious disease that can be life-threatening, especially if left untreated. Compared to the overall population, people with pyoderma gangrenosum are three times more likely to die than their peers of the same age. […] Pyoderma gangrenosum is a chronic condition, so once you have it, you’ll likely need to manage it throughout your life. It can be an unpredictable condition to live with and has some scary implications including a death rate that’s higher than it is for people without the condition.

• #59 Clinicopathological features and prognosis of pyoderma gangrenosum in Korea: A single centre, retrospective, observational study over 20 years – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/clinicopathological-features-and-prognosis-of-pyoderma-gangrenosum-in-korea-a-single-center-retrospective-observational-study-over-20-years/

  Pyoderma gangrenosum is a rare autoinflammatory neutrophilic dermatosis that rapidly evolves. However, little is known about the clinicopathological features and prognosis of pyoderma gangrenosum. The most frequently affected area was the lower extremities (60.4%), followed by the head and neck (17.0%). The most common subtype was ulcerative (47.2%), followed by bullous (22.6%). Partial-to-complete remission was observed in 40 cases (75.5%). Nine (17.0%) cases experienced recurrence with a median progression-free period of six months (interquartile range of 3.0-9.0 months). Cases with underlying hematologic disorders and the bullous subtype were significantly associated with early recurrence. Pyoderma gangrenosum appears to have ethnic differences. Underlying haematologic disorders and bullous subtype have a worse prognosis. However, the type of histopathology did not correlate with the clinical outcome of pyoderma gangrenosum.

• #60 Pyoderma Gangrenosum: Symptoms, Causes, Treatment

  https://www.verywellhealth.com/pyoderma-gangrenosum-8364747

  Pyoderma gangrenosum (PG) is a rare, chronic skin condition that causes a painful rash leading to ulcers or open sores. Initially, the rash may look like a blood pimple or a blood blister that wont go away. Over time, skin around the blister deteriorates, leaving an open wound. […] The most prominent symptom of pyoderma gangrenosum is open ulcers filled with fibrinous debris. People with atypical pyoderma gangrenosum might not develop these ulcers. These ulcers usually start with a small rash that spreads quickly. The ulcers might continue spreading or heal on their own. […] In addition to ulcers, other symptoms of pyoderma gangrenosum include fever, localized pain around the rash and ulcers, feeling generally unwell, and joint pain. […] Pyoderma gangrenosum is a serious disease that can be life-threatening, especially if left untreated. Compared to the overall population, people with pyoderma gangrenosum are three times more likely to die than their peers of the same age. […] Pyoderma gangrenosum is a chronic condition, so once you have it, you’ll likely need to manage it throughout your life. It can be an unpredictable condition to live with and has some scary implications including a death rate that’s higher than it is for people without the condition.

• #61 Pyoderma Gangrenosum: Symptoms and Treatment | Doctor

  https://patient.info/doctor/pyoderma-gangrenosum-pro

  Pustular PG […] There are multiple sterile pustules surrounded by an erythematous halo and associated with fever and arthralgias. […] It often improves with treatment of the underlying IBD. […] Genital PG […] Typical PG ulcers located on the vulva, penis or scrotum. […] Behet’s disease should be considered as a differential diagnosis. […] Extracutaneous neutrophilic disease […] Sterile neutrophilic infiltrates – usually in the lungs, but can also occur in the heart, central nervous system, gastrointestinal tract, eye, liver, spleen and lymph nodes. […] Symptoms reflect the location of the lesions. […] Oral involvement has also been reported. […] Prognosis […] The clinical course is variable and difficult to predict. There may be spontaneous resolution, a quiescent phase for months or years or flare-ups following minimal trauma or for no apparent cause. […] Any underlying disease significantly affects the prognosis. […] Male sex, older age, bullous variety and association with haematological malignancy are associated with poorer prognosis. […] A UK-based study found that people with PG had a three times higher risk of death than the general population.

• #62 Pyoderma Gangrenosum – Dermatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.856.5.

  Factors associated with poor prognosis include increased disease severity; older age at diagnosis; ulcerative and bullous variants; and underlying disease, superinfection, and sepsis unresponsive to treatment. Ulcer recurrence occurs in 70% of patients treated with prednisolone and in 66% of those treated with cyclosporine. Ultimately, despite advances in PG treatment, the prognosis is unpredictable due to the chronic, relapsing nature of PG and its complications with a mortality rate of up to 30%.

• #63 Pyoderma gangrenosum – a review | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/1750-1172-2-19

  Pyoderma gangrenosum (PG) is a rare noninfectious neutrophilic dermatosis. Clinically it starts with sterile pustules that rapidly progress and turn into painful ulcers of variable depth and size with undermined violaceous borders. The ulcer starts as a follicular pustule with rapid growth, tissue necrosis and enlargement of the area. The surrounding skin is erythematous with infiltration end oedema. The ulcer borders are typically undermined and violaceous or bluish. A strong sensation of pain often is associated to PG. The PG-ulcers associated with arthritis seem to have a poorer prognosis than others. In a study covering 2 years 78.9% of PG-ulcers in general healed versus only 23.4% in arthritis-associated PG. Despite advances in management, the long term outcome of PG remains unpredictable. PG is still a potentially life-threatening with a mortality rate of up to 30% in some series.

• #64 Pyoderma gangrenosum – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/symptoms-causes/syc-20350386

  Pyoderma gangrenosum can cause painful, open sores that have blue or purple edges. […] Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores on the skin. The sores can develop quickly. Most often they appear on the legs. […] Pyoderma gangrenosum usually starts with a small bump on the skin. It might look like a spider bite. Within days it can turn into a large and painful open sore. […] The sore usually appears on the legs but may develop anywhere on the body. Sometimes it appears around surgical sites. If you have two or more sores, they may grow and merge into one. […] Possible complications of pyoderma gangrenosum include infection, uncontrolled pain, scarring and and changes in skin color after the affected skin heals. This change in skin color is called postinflammatory hyperpigmentation when the skin darkens and postinflammatory hypopigmentation when the skin loses color. People with brown or Black skin have a higher risk of long-term skin color changes.

• #65 Pyoderma gangrenosum

  https://ask-ahd.ahdubai.com/con-20154762

  Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores (ulcers) to develop on your skin, most often on your legs. […] Pyoderma gangrenosum ulcers can develop quickly. They usually clear up with treatment, but scarring and recurrences are common. […] Pyoderma gangrenosum usually starts with a small, red bump on your skin, which may resemble a spider bite. Within days, this bump can develop into a large, painful open sore. […] The ulcer usually appears on your legs, but may develop anywhere on your body. Sometimes it appears around surgical sites. If you have several ulcers, they may grow and merge into one larger ulcer. […] Possible complications of pyoderma gangrenosum include infection, scarring, uncontrolled pain, depression and loss of mobility. […] Even after successful treatment, it’s common for new wounds to develop.

• #66

  https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/pyoderma-gangrenosum

  Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores (ulcers) to develop on your skin, most often on your legs. […] Pyoderma gangrenosum ulcers can develop quickly. They usually clear up with treatment, but scarring and recurrences are common. […] Pyoderma gangrenosum usually starts with a small, red bump on your skin, which may resemble a spider bite. Within days, this bump can develop into a large, painful open sore. […] The ulcer usually appears on your legs, but may develop anywhere on your body. Sometimes it appears around surgical sites. If you have several ulcers, they may grow and merge into one larger ulcer. […] Talk to your doctor if you develop a painful, rapidly growing skin wound. […] Possible complications of pyoderma gangrenosum include infection, scarring, uncontrolled pain, depression and loss of mobility.

• #67 Pyoderma gangrenosum – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/symptoms-causes/syc-20350386

  Pyoderma gangrenosum can cause painful, open sores that have blue or purple edges. […] Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores on the skin. The sores can develop quickly. Most often they appear on the legs. […] Pyoderma gangrenosum usually starts with a small bump on the skin. It might look like a spider bite. Within days it can turn into a large and painful open sore. […] The sore usually appears on the legs but may develop anywhere on the body. Sometimes it appears around surgical sites. If you have two or more sores, they may grow and merge into one. […] Possible complications of pyoderma gangrenosum include infection, uncontrolled pain, scarring and and changes in skin color after the affected skin heals. This change in skin color is called postinflammatory hyperpigmentation when the skin darkens and postinflammatory hypopigmentation when the skin loses color. People with brown or Black skin have a higher risk of long-term skin color changes.

• #68 Pyoderma Gangrenosum: Background, Epidemiology, Prognosis

  https://emedicine.medscape.com/article/1123821-overview

  The prognosis for patients with pyoderma gangrenosum is generally good; however, the disease may recur, and residual scarring is common. One study reported that 16% of their 103 patients died during the 8-year study period. Pain is a common patient complaint and may require pain medication for control. […] Most patients with pyoderma gangrenosum improve with initial immunosuppressive therapy and require minimal care afterwards. However, many patients follow a refractory course, and multiple therapies may fail. These patients pose a difficult clinical problem that necessitates frequent follow-up and long-term care. […] Some patients demonstrate pathergy, or the development of pyoderma gangrenosumlike lesions at the site of skin trauma; in such instances, protection of the skin from trauma may prevent a recurrence of the disease. Pathergy may create problems with wound healing, especially after surgical procedures (eg, breast reconstruction or grafting). […] Death from pyoderma gangrenosum is rare, but it may occur as a consequence of an associated disease or as a result of therapy.

• #69 Pyoderma gangrenosum – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/symptoms-causes/syc-20350386

  Pyoderma gangrenosum can cause painful, open sores that have blue or purple edges. […] Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores on the skin. The sores can develop quickly. Most often they appear on the legs. […] Pyoderma gangrenosum usually starts with a small bump on the skin. It might look like a spider bite. Within days it can turn into a large and painful open sore. […] The sore usually appears on the legs but may develop anywhere on the body. Sometimes it appears around surgical sites. If you have two or more sores, they may grow and merge into one. […] Possible complications of pyoderma gangrenosum include infection, uncontrolled pain, scarring and and changes in skin color after the affected skin heals. This change in skin color is called postinflammatory hyperpigmentation when the skin darkens and postinflammatory hypopigmentation when the skin loses color. People with brown or Black skin have a higher risk of long-term skin color changes.

• #70 Pyoderma Gangrenosum in Ulcerative Colitis | MyCrohnsAndColitisTeam

  https://www.mycrohnsandcolitisteam.com/resources/pyoderma-gangrenosum-in-ulcerative-colitis

  People who develop lesions due to pyoderma gangrenosum may experience moderate to severe pain, which can escalate to uncontrolled pain and even loss of mobility. […] The ongoing pain may disrupt daily life, affecting eating patterns and causing sleep disturbances. […] Early diagnosis is crucial to slowing the diseases progression and preventing these complications. […] Getting an early diagnosis and effective treatment can help people with ulcerative colitis avoid the severe physical and emotional impacts of pyoderma gangrenosum.

• #71 Pyoderma gangrenosum – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/symptoms-causes/syc-20350386

  Pyoderma gangrenosum can cause painful, open sores that have blue or purple edges. […] Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores on the skin. The sores can develop quickly. Most often they appear on the legs. […] Pyoderma gangrenosum usually starts with a small bump on the skin. It might look like a spider bite. Within days it can turn into a large and painful open sore. […] The sore usually appears on the legs but may develop anywhere on the body. Sometimes it appears around surgical sites. If you have two or more sores, they may grow and merge into one. […] Possible complications of pyoderma gangrenosum include infection, uncontrolled pain, scarring and and changes in skin color after the affected skin heals. This change in skin color is called postinflammatory hyperpigmentation when the skin darkens and postinflammatory hypopigmentation when the skin loses color. People with brown or Black skin have a higher risk of long-term skin color changes.

• #72 Pyoderma gangrenosum

  https://ask-ahd.ahdubai.com/con-20154762

  Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores (ulcers) to develop on your skin, most often on your legs. […] Pyoderma gangrenosum ulcers can develop quickly. They usually clear up with treatment, but scarring and recurrences are common. […] Pyoderma gangrenosum usually starts with a small, red bump on your skin, which may resemble a spider bite. Within days, this bump can develop into a large, painful open sore. […] The ulcer usually appears on your legs, but may develop anywhere on your body. Sometimes it appears around surgical sites. If you have several ulcers, they may grow and merge into one larger ulcer. […] Possible complications of pyoderma gangrenosum include infection, scarring, uncontrolled pain, depression and loss of mobility. […] Even after successful treatment, it’s common for new wounds to develop.

• #73 Pyoderma gangrenosum – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/symptoms-causes/syc-20350386

  Pyoderma gangrenosum can cause painful, open sores that have blue or purple edges. […] Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores on the skin. The sores can develop quickly. Most often they appear on the legs. […] Pyoderma gangrenosum usually starts with a small bump on the skin. It might look like a spider bite. Within days it can turn into a large and painful open sore. […] The sore usually appears on the legs but may develop anywhere on the body. Sometimes it appears around surgical sites. If you have two or more sores, they may grow and merge into one. […] Possible complications of pyoderma gangrenosum include infection, uncontrolled pain, scarring and and changes in skin color after the affected skin heals. This change in skin color is called postinflammatory hyperpigmentation when the skin darkens and postinflammatory hypopigmentation when the skin loses color. People with brown or Black skin have a higher risk of long-term skin color changes.

• #74 Pyoderma gangrenosum

  https://ask-ahd.ahdubai.com/con-20154762

  Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores (ulcers) to develop on your skin, most often on your legs. […] Pyoderma gangrenosum ulcers can develop quickly. They usually clear up with treatment, but scarring and recurrences are common. […] Pyoderma gangrenosum usually starts with a small, red bump on your skin, which may resemble a spider bite. Within days, this bump can develop into a large, painful open sore. […] The ulcer usually appears on your legs, but may develop anywhere on your body. Sometimes it appears around surgical sites. If you have several ulcers, they may grow and merge into one larger ulcer. […] Possible complications of pyoderma gangrenosum include infection, scarring, uncontrolled pain, depression and loss of mobility. […] Even after successful treatment, it’s common for new wounds to develop.

• #75 Pyoderma Gangrenosum in Ulcerative Colitis | MyCrohnsAndColitisTeam

  https://www.mycrohnsandcolitisteam.com/resources/pyoderma-gangrenosum-in-ulcerative-colitis

  People who develop lesions due to pyoderma gangrenosum may experience moderate to severe pain, which can escalate to uncontrolled pain and even loss of mobility. […] The ongoing pain may disrupt daily life, affecting eating patterns and causing sleep disturbances. […] Early diagnosis is crucial to slowing the diseases progression and preventing these complications. […] Getting an early diagnosis and effective treatment can help people with ulcerative colitis avoid the severe physical and emotional impacts of pyoderma gangrenosum.

• #76 Pyoderma Gangrenosum: A Diagnostic Challenge for the Surgical Consultant | ACS

  https://www.facs.org/for-medical-professionals/news-publications/journals/case-reviews/issues/v4n1/harrington-pyoderma-gangrenosum/

  Given the frequency with which pathergy is associated with PG, wound care must avoid adherent dressings and irritating solutions. […] Further, any unnecessary manipulation of the ulcer bed should be avoided. […] Significant mortality in PG patients is associated with overwhelming sepsis, varying from 1.12% to 21.7% in different cohorts.

• #77 Pyoderma Gangrenosum: Background, Epidemiology, Prognosis

  https://emedicine.medscape.com/article/1123821-overview

  Pyoderma gangrenosum is an uncommon ulcerative cutaneous condition whose cause is uncertain. Although the etiology of this condition is poorly understood, dysregulation of the immune system (specifically, altered neutrophil chemotaxis) is believed to be involved. Pyoderma gangrenosum is associated with systemic diseases in at least 50% of patients who are affected. […] The diagnosis is made by excluding other causes of similar-appearing cutaneous ulcerations, including infection, malignancy, vasculitis, vasculopathy, venous insufficiency, collagen-vascular diseases, diabetes, and trauma. In a process termed pathergy, new ulcerations may occur after trauma or injury to the skin in 30% of patients who already have pyoderma gangrenosum. […] Patients with pyoderma gangrenosum may have involvement of other organ systems that manifests as sterile neutrophilic infiltrates. Culture-negative pulmonary infiltrates are the most common extracutaneous manifestation. Other organ systems that may be involved include the heart, the central nervous system (CNS), the gastrointestinal (GI) tract, the eyes, the liver, the spleen, the bones, and the lymph nodes.

• #78 Pyoderma Gangrenosum – Skin Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/skin-disorders/hypersensitivity-and-reactive-skin-disorders/pyoderma-gangrenosum

  Pyoderma gangrenosum is a chronic inflammatory skin disorder of unknown cause that causes large sores on the skin. […] This disorder begins as small bumps or blisters that become open sores. […] Most often, pyoderma gangrenosum begins as a red bump that may resemble a pimple or an insect bite. Less often, it begins as a blister. The bump or blister then becomes an open, painful sore (ulcer) that expands rapidly. The sores have a raised border that is dusky or purple. The sores can grow together to form larger sores. People often are left with scars after sores heal. […] People commonly have fever and a general feeling of illness (malaise). […] Pyoderma gangrenosum can also develop at other locations, such as in the abdominal wall around a colostomy or ileostomy opening in people who have inflammatory bowel disease, or on the genitals or buttocks. In some people with pyoderma gangrenosum, areas other than the skin, such as the bones, lungs, heart, liver, or muscles, are affected. […] The diagnosis of pyoderma gangrenosum is strongly suggested if the sores worsen after minor trauma or a surgical procedure (such as a skin biopsy). […] Cyclosporine can be very effective, particularly for people whose disease is progressing rapidly.

• #79 Pyoderma Gangrenosum – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/pyoderma-gangrenosum/

  PG must be considered as a systemic disease, from two points of view: (1) some PG patients have extracutaneous neutrophilic infiltrates (the neutrophilic disease), and (2) PG is often associated with a multisystemic disorder. […] Aseptic neutrophilic abscesses similar to PG may occur in extracutaneous sites. The main localizations of the neutrophilic disease are the lungs and the joints, but all organs may be involved. […] In severe, recalcitrant PG, or in cases with contraindications or intolerance to steroids, cyclosporine (3-5mg/kg/day) is probably the best option. Other immunosuppressive drugs such as methotrexate, mycophenolate mofetil, and azathioprine have given good results, usually in association with oral steroids. […] In chronic, paucilesional PG, steroid-sparing antiinflammatory drugs can be useful. These are dapsone, clofazimine, minocycline. In recurrent cases, prompt treatment with intra-lesional injections of triamcinolone acetonide (10-40mg/ml) can be effective in aborting development of large ulcerated lesions.

• #80 Pyoderma Gangrenosum – Dermatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.856.5.

  Pyoderma gangrenosum (PG) is a neutrophilic ulcerative dermatosis with a spectrum of clinical presentations and variable clinical course. PG commonly affects women aged 20 to 50 years and occurs on the lower extremities, but it can involve any area of the body, including the head and neck in children and the genital and perianal areas in infants. Lesions are usually limited to 1 to 3, with 5% of body surface area (BSA) involved. The course of PG can be indolent, aggressive, or fulminant. PG often demonstrates a chronic, relapsing course. Worsening or development of new lesions after a trauma (known as pathergy) is a common characteristic of active PG. […] Classic ulcerative PG: It is the most common PG variant that most frequently affects the legs. It is characterized by a rapidly progressing painful wound with a peripheral red halo and raised red-purple undermined edges. Systemic symptoms are common in classic ulcerative PG, including fever, malaise, arthralgia, and myalgia. The lung is the most common extracutaneous organ involved in patients with PG. Pulmonary involvement may range from asymptomatic presentation to severe respiratory distress.

• #81 Pyoderma Gangrenosum – Dermatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.856.5.

  The average time between surgery and onset of symptoms of postsurgical PG is 11 days; the risk of postsurgical recurrence in future surgeries of a person with PG is 15%. […] Pustular PG is a rare, superficial PG variant beginning as a sterile inflammatory pustule or a group of sterile pustules that coalesce and ulcerate to the pustular stage with a red halo. These ulcers are painful and can regress without scarring or persist for months and evolve into classic PG. […] Bullous PG is a rare PG variant that predominantly occurs on the upper limbs, face, dorsum of the hands, or extensor surfaces of the arms. Bullous PG has a poor prognosis due to its association with hematologic conditions and malignancies such as acute myelogenous leukemia. […] Systemic symptoms are common in classic ulcerative PG, including fever, malaise, arthralgia, and myalgia. The lung is the most common extracutaneous organ involved in patients with PG. Pulmonary involvement may range from asymptomatic presentation to severe respiratory distress.

• #82 Pyoderma gangrenosum: challenges and solutions | CCID

  https://www.dovepress.com/pyoderma-gangrenosum-challenges-and-solutions-peer-reviewed-fulltext-article-CCID

  Pyoderma gangrenosum (PG) is a rare inflammatory skin disease with a chronic relapsing course, commonly associated with severe pain and tenderness that often regresses with cribriform mutilating scars. PG has been estimated to occur in three to ten individuals/million. However, it is difficult to determine the exact disease prevalence, as accurate epidemiological data are missing. PG is most commonly observed in young to middle-aged adults, with women being more affected. Cases in elderly people have been reported occasionally, and childhood PG accounts for approximately 4% of the cases. Classically, lesions begin as tender papules, papulopustules or vesicles, evolving into painful and rapidly enlarging ulcers. Healing frequently leaves a cribriform scar, which may lead to considerable disfiguring. On histology, PG lesions do not display specific features, being typically characterized by a prominent dermal neutrophilic infiltrate with abscess formation, with no signs of infection and usually without significant vasculopathy. The disease usually has a devastating effect on a patients life: pain may alter the eating and sleeping patterns; may induce significant movement impairment depending on lesions location; and treatment usually implies numerous hospital appointments. Additionally, the characteristic features of the wound, such as malodor or exudate, may trigger or aggravate anxiety, depression, and social isolation.

• #83 Pyoderma gangrenosum symptoms, treatments & forums | PatientsLikeMe

  https://www.patientslikeme.com/conditions/pyoderma-gangrenosum

  Pyoderma Gangrenosum is an uncommon skin disease that causes deep ulcers and usually occurs on the legs. The cause is unclear however, it has been linked to patients that also have other autoimmune diseases. […] Common symptom Pain […] 11 pyoderma gangrenosum patients report severe pain (32%) […] 10 pyoderma gangrenosum patients report moderate pain (29%) […] 11 pyoderma gangrenosum patients report mild pain (32%) […] 2 pyoderma gangrenosum patients report no pain (5%). […] Common symptom Fatigue […] 10 pyoderma gangrenosum patients report severe fatigue (29%) […] 11 pyoderma gangrenosum patients report moderate fatigue (32%) […] 9 pyoderma gangrenosum patients report mild fatigue (26%) […] 4 pyoderma gangrenosum patients report no fatigue (11%). […] Common symptom Stress

• #84 Pyoderma gangrenosum symptoms, treatments & forums | PatientsLikeMe

  https://www.patientslikeme.com/conditions/pyoderma-gangrenosum

  1 a pyoderma gangrenosum patient reports severe stress (25%) […] 2 pyoderma gangrenosum patients report moderate stress (50%) […] 1 a pyoderma gangrenosum patient reports mild stress (25%) […] 0 pyoderma gangrenosum patients report no stress (0%). […] Common symptom Depressed mood […] 4 pyoderma gangrenosum patients report severe depressed mood (11%) […] 9 pyoderma gangrenosum patients report moderate depressed mood (25%) […] 11 pyoderma gangrenosum patients report mild depressed mood (31%) […] 11 pyoderma gangrenosum patients report no depressed mood (31%). […] Common symptom Anxious mood […] 3 pyoderma gangrenosum patients report severe anxious mood (9%) […] 9 pyoderma gangrenosum patients report moderate anxious mood (28%) […] 11 pyoderma gangrenosum patients report mild anxious mood (34%) […] 9 pyoderma gangrenosum patients report no anxious mood (28%).

• #85 Pyoderma gangrenosum: challenges and solutions | CCID

  https://www.dovepress.com/pyoderma-gangrenosum-challenges-and-solutions-peer-reviewed-fulltext-article-CCID

  Pyoderma gangrenosum (PG) is a rare inflammatory skin disease with a chronic relapsing course, commonly associated with severe pain and tenderness that often regresses with cribriform mutilating scars. PG has been estimated to occur in three to ten individuals/million. However, it is difficult to determine the exact disease prevalence, as accurate epidemiological data are missing. PG is most commonly observed in young to middle-aged adults, with women being more affected. Cases in elderly people have been reported occasionally, and childhood PG accounts for approximately 4% of the cases. Classically, lesions begin as tender papules, papulopustules or vesicles, evolving into painful and rapidly enlarging ulcers. Healing frequently leaves a cribriform scar, which may lead to considerable disfiguring. On histology, PG lesions do not display specific features, being typically characterized by a prominent dermal neutrophilic infiltrate with abscess formation, with no signs of infection and usually without significant vasculopathy. The disease usually has a devastating effect on a patients life: pain may alter the eating and sleeping patterns; may induce significant movement impairment depending on lesions location; and treatment usually implies numerous hospital appointments. Additionally, the characteristic features of the wound, such as malodor or exudate, may trigger or aggravate anxiety, depression, and social isolation.

• #86 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  This is an important but rare clinical variant that presents with destructive ulceration typically affecting the upper torso, head and neck. Lesions do not display the violaceous edge seen in classical PG and the condition is not associated with systemic disease. […] Underlying systemic conditions are found in up to 50% of cases and so it is imperative to try and identify such conditions once a diagnosis of PG has been made. […] Despite being a well-recognised condition, there is often a failure to make an early diagnosis of PG. It is important for all clinicians to be aware of this condition and to actively consider PG when assessing patients with ulcers, as appropriate and prompt treatment at an early stage of the disease may avoid the complications of prolonged systemic treatment, delayed wound healing and scarring.

• #87 Pyoderma Gangrenosum: Background, Epidemiology, Prognosis

  https://emedicine.medscape.com/article/1123821-overview

  Pyoderma gangrenosum is an uncommon ulcerative cutaneous condition whose cause is uncertain. Although the etiology of this condition is poorly understood, dysregulation of the immune system (specifically, altered neutrophil chemotaxis) is believed to be involved. Pyoderma gangrenosum is associated with systemic diseases in at least 50% of patients who are affected. […] The diagnosis is made by excluding other causes of similar-appearing cutaneous ulcerations, including infection, malignancy, vasculitis, vasculopathy, venous insufficiency, collagen-vascular diseases, diabetes, and trauma. In a process termed pathergy, new ulcerations may occur after trauma or injury to the skin in 30% of patients who already have pyoderma gangrenosum. […] Patients with pyoderma gangrenosum may have involvement of other organ systems that manifests as sterile neutrophilic infiltrates. Culture-negative pulmonary infiltrates are the most common extracutaneous manifestation. Other organ systems that may be involved include the heart, the central nervous system (CNS), the gastrointestinal (GI) tract, the eyes, the liver, the spleen, the bones, and the lymph nodes.

• #88 Is Pyoderma Gangrenosum Caused By Ulcerative Colitis?

  https://www.healthline.com/health/ulcerative-colitis/pyoderma-gangrenosum-ulcerative-colitis

  Pyoderma gangrenosum is a rare symptom of inflammatory bowel disease that causes lesions to appear on your skin. […] One study estimated that 2% of people with ulcerative colitis have pyoderma gangrenosum. […] Skin manifestations of ulcerative colitis usually appear within the first 2 years after diagnosis. […] What this means is that ulcerative colitis does increase the likelihood you could experience pyoderma gangrenosum. However, having ulcerative colitis doesnt mean youll get pyoderma gangrenosum, as only a small percentage of those with UC experience this skin complication. […] Pyoderma gangrenosum causes small, red or purplish bumps to appear on the skin. Sometimes, these may be blisters that can become swollen, open sores. These sores tend to have a deep blue or violet-colored outline.

• #89 Pyoderma Gangrenosum Associated With Inflammatory Bowel Disease. Report of Two Cases With Good Response to Infliximab | Reumatología Clínica

  https://www.reumatologiaclinica.org/en-pyoderma-gangrenosum-associated-with-inflammatory-articulo-S2173574312000068

  Among the extraintestinal manifestations of inflammatory bowel disease (IBD), pyoderma gangrenosum (PG) often poses a therapeutic challenge. We describe two cases of PG associated with inflammatory bowel disease, who responded to treatment with Infliximab. […] Pyoderma gangrenosum (PG) is a neutrophilic dermatosis of unknown cause that manifests as painful skin ulcers. […] It is more common in ulcerative colitis than Crohn’s disease, and manifests itself initially as painful pustules that increase in size forming ulcers with purple edges and a necrotic base, may be multiple and scars after healing. It is most frequently located in the lower extremities. […] PG can respond to the basic treatment of IBD, but its relationship disease activity is less obvious than in other mucocutaneous extraintestinal manifestations, such as erythema nodosum.

• #90 Pyoderma Gangrenosum Associated With Inflammatory Bowel Disease. Report of Two Cases With Good Response to Infliximab | Reumatología Clínica

  https://www.reumatologiaclinica.org/en-pyoderma-gangrenosum-associated-with-inflammatory-articulo-S2173574312000068

  Among the extraintestinal manifestations of inflammatory bowel disease (IBD), pyoderma gangrenosum (PG) often poses a therapeutic challenge. We describe two cases of PG associated with inflammatory bowel disease, who responded to treatment with Infliximab. […] Pyoderma gangrenosum (PG) is a neutrophilic dermatosis of unknown cause that manifests as painful skin ulcers. […] It is more common in ulcerative colitis than Crohn’s disease, and manifests itself initially as painful pustules that increase in size forming ulcers with purple edges and a necrotic base, may be multiple and scars after healing. It is most frequently located in the lower extremities. […] PG can respond to the basic treatment of IBD, but its relationship disease activity is less obvious than in other mucocutaneous extraintestinal manifestations, such as erythema nodosum.

• #91 Pyoderma Gangrenosum in a Patient with Inactive Ulcerative Colitis

  https://www.kjg.or.kr/journal/view.html?uid=5571&vmd=Full

  CASE: A 40-year-old woman presented with complaints of intractable ulcers over her legs that had been present for 2 years. An ulcer on her left leg began 2 years ago, and the other on her right foot 2 months ago. […] At the time of the hospital visit, her skin lesions had progressively worsened for 6 months without any gastrointestinal symptoms (a partial Mayo score of 0). […] The physical examination revealed an ulcer measuring 58 cm over the lower third of her left leg and the other measuring 33 cm over her right ankle. Gross examination of the ulcers revealed that they were well defined with elevated reddish borders and undermined edges; the bases were covered with necrotic skin and purulent discharge. […] Subsequently, the ulcers on her legs were diagnosed as pyoderma gangrenosum (PG) as an extraintestinal manifestation (EIM) of UC.

• #92 Pyoderma Gangrenosum in a Patient with Inactive Ulcerative Colitis

  https://www.kjg.or.kr/journal/view.html?uid=5571&vmd=Full

  PG is a chronic ulcerative skin disease that usually develops in the early stages of the onset of UC, with the appearance of erythematous and indurated skin lesions that evolve into ulcers with well-defined borders. Such an ulcer begins as a small papule that rapidly grows, develops necrosis, and becomes an enlarged ulcer, which is surrounded by a purple rim and bright red erythema. […] The management of PG includes local wound care in conjunction with systemic therapy with immunomodulating agents. […] In conclusion, PG may be a complication of inactive UC, and PG may be independent of the activity of bowel inflammation and the further development of preceding bowel symptoms. PG as a complication of UC can be successfully treated with azathioprine monotherapy.

• #93 Pyoderma Gangrenosum – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/hypersensitivity-and-reactive-skin-disorders/pyoderma-gangrenosum

  Most often, pyoderma gangrenosum begins as an inflamed, erythematous papule, pustule, or nodule. The lesion, which may resemble a furuncle or an arthropod bite at this stage, ulcerates and expands rapidly, developing a swollen necrotic base and a raised dusky to violaceous border. An undermined border (ie, loss of underlying support tissue at the border) is common, if not pathognomonic. The ulcers can coalesce to form larger ulcers, often with cribriform or sieve-like scarring. […] Systemic symptoms such as fever and malaise are common. […] Symptoms and signs can vary with the subtype. […] In this most common subtype, ulcers form as described above, most commonly on the lower extremities or trunk, particularly the buttocks and perineum. […] This less common subtype often develops in patients with hematologic disorders. Lesions usually begin as bullae that erode, becoming superficial ulcers. The arms and face are most often involved.

• #94 Pyoderma Gangrenosum – Dermatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.856.5.

  The average time between surgery and onset of symptoms of postsurgical PG is 11 days; the risk of postsurgical recurrence in future surgeries of a person with PG is 15%. […] Pustular PG is a rare, superficial PG variant beginning as a sterile inflammatory pustule or a group of sterile pustules that coalesce and ulcerate to the pustular stage with a red halo. These ulcers are painful and can regress without scarring or persist for months and evolve into classic PG. […] Bullous PG is a rare PG variant that predominantly occurs on the upper limbs, face, dorsum of the hands, or extensor surfaces of the arms. Bullous PG has a poor prognosis due to its association with hematologic conditions and malignancies such as acute myelogenous leukemia. […] Systemic symptoms are common in classic ulcerative PG, including fever, malaise, arthralgia, and myalgia. The lung is the most common extracutaneous organ involved in patients with PG. Pulmonary involvement may range from asymptomatic presentation to severe respiratory distress.

• #95 Pyoderma Gangrenosum – Dermatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.856.5.

  The average time between surgery and onset of symptoms of postsurgical PG is 11 days; the risk of postsurgical recurrence in future surgeries of a person with PG is 15%. […] Pustular PG is a rare, superficial PG variant beginning as a sterile inflammatory pustule or a group of sterile pustules that coalesce and ulcerate to the pustular stage with a red halo. These ulcers are painful and can regress without scarring or persist for months and evolve into classic PG. […] Bullous PG is a rare PG variant that predominantly occurs on the upper limbs, face, dorsum of the hands, or extensor surfaces of the arms. Bullous PG has a poor prognosis due to its association with hematologic conditions and malignancies such as acute myelogenous leukemia. […] Systemic symptoms are common in classic ulcerative PG, including fever, malaise, arthralgia, and myalgia. The lung is the most common extracutaneous organ involved in patients with PG. Pulmonary involvement may range from asymptomatic presentation to severe respiratory distress.

• #96 Pyoderma Gangrenosum With Systemic Symptoms Initially Misdiagnosed as Cellulitis | Consultant360

  https://www.consultant360.com/article/consultant360/pyoderma-gangrenosum-systemic-symptoms-initially-misdiagnosed-cellulitis

  Systemic symptoms such as fever, malaise, arthralgia, and myalgia may be present, and PG may present as part of an autoinflammatory syndrome such as PAPA (pyogenic arthritis, PG, and acne), PAPASH (pyogenic arthritis, PG, acne, and hidradenitis suppurativa), or PASH (PG, acne, and hidradenitis suppurativa). […] PG is a rare neutrophilic dermatosis that classically presents as rapidly progressing red to violaceous cutaneous ulcers with undermined borders and a purulent base on the lower leg or abdomen. […] Because of its varied clinical morphology and presentation, nonspecific histopathology, and systemic symptoms mimicking infection, a high index of suspicion for PG must be maintained.

• #97 New Clinical Features of Pyogenic Arthritis, Pyoderma Gangrenosum, and Acne Syndrome – ACR Meeting Abstracts

  https://acrabstracts.org/abstract/new-clinical-features-of-pyogenic-arthritis-pyoderma-gangrenosum-and-acne-syndrome/

  The dominantly inherited pyogenic arthritis pyoderma gangrenosum and acne (PAPA) syndrome is caused by mutations in PSTPIP1. Associated symptoms include arthritis, cystic acne, and pyoderma gangrenosum without discernable infection. […] Our findings indicate new clinical features in PAPA that include aseptic supraglottitis and non-bacterial osteomyelitis. Improvement in clinical symptoms, radiographic findings, and acute phase reactants as well as a normal WBC support an inflammatory rather than infectious process.

• #98 New Clinical Features of Pyogenic Arthritis, Pyoderma Gangrenosum, and Acne Syndrome – ACR Meeting Abstracts

  https://acrabstracts.org/abstract/new-clinical-features-of-pyogenic-arthritis-pyoderma-gangrenosum-and-acne-syndrome/

  The dominantly inherited pyogenic arthritis pyoderma gangrenosum and acne (PAPA) syndrome is caused by mutations in PSTPIP1. Associated symptoms include arthritis, cystic acne, and pyoderma gangrenosum without discernable infection. […] Our findings indicate new clinical features in PAPA that include aseptic supraglottitis and non-bacterial osteomyelitis. Improvement in clinical symptoms, radiographic findings, and acute phase reactants as well as a normal WBC support an inflammatory rather than infectious process.

• #99 Pyoderma gangrenosum – Wikipedia

  https://en.wikipedia.org/wiki/Pyoderma_gangrenosum

  Pyoderma gangrenosum is a rare, inflammatory skin disease where painful pustules or nodules become ulcers that progressively grow. […] The disease was identified in 1930. It affects approximately 1 person in 100,000 in the population. Though it can affect people of any age, it mostly affects people in their 40s and 50s. […] One hallmark of pyoderma gangrenosum is pathergy, which is the appearance of new lesions at sites of trauma, including surgical wounds. […] Diagnosis of PG is challenging owing to its variable presentation, clinical overlap with other conditions, association with several systemic diseases, and absence of defining histopathologic or laboratory findings. Misdiagnosis and delayed diagnosis are common. It has been shown that up to 39% of patients who initially received a diagnosis of PG have an alternative diagnosis. […] First-line therapy for disseminated or localized instances of pyoderma gangrenosum is systemic treatment with corticosteroids and ciclosporin.

• #100 Pyoderma gangrenosum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/diagnosis-treatment/drc-20350392

  Your healthcare professional will talk with you about your symptoms and medical history and conduct a physical exam. […] No test can confirm a diagnosis of pyoderma gangrenosum. But you may need tests to rule out other conditions that have similar symptoms. […] Treatment of pyoderma gangrenosum is aimed at reducing swelling, controlling pain and helping skin sores heal. […] Some people respond well to treatment with a combination of medicine taken by mouth, creams and injections. […] Sores can take weeks or months to heal, and it’s common for new ones to develop. […] Because pyoderma gangrenosum can be made worse by cuts to the skin, surgery to remove dead tissue is not usually considered a good treatment option. […] If sores are large and aren’t healing, a skin graft may be an option. […] With treatment you’re likely to recover from pyoderma gangrenosum. It may take a long time and you may feel stressed about whether new sores will form.

• #101 Pyoderma gangrenosum – Wikipedia

  https://en.wikipedia.org/wiki/Pyoderma_gangrenosum

  Pyoderma gangrenosum is a rare, inflammatory skin disease where painful pustules or nodules become ulcers that progressively grow. […] The disease was identified in 1930. It affects approximately 1 person in 100,000 in the population. Though it can affect people of any age, it mostly affects people in their 40s and 50s. […] One hallmark of pyoderma gangrenosum is pathergy, which is the appearance of new lesions at sites of trauma, including surgical wounds. […] Diagnosis of PG is challenging owing to its variable presentation, clinical overlap with other conditions, association with several systemic diseases, and absence of defining histopathologic or laboratory findings. Misdiagnosis and delayed diagnosis are common. It has been shown that up to 39% of patients who initially received a diagnosis of PG have an alternative diagnosis. […] First-line therapy for disseminated or localized instances of pyoderma gangrenosum is systemic treatment with corticosteroids and ciclosporin.

• #102 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  This is an important but rare clinical variant that presents with destructive ulceration typically affecting the upper torso, head and neck. Lesions do not display the violaceous edge seen in classical PG and the condition is not associated with systemic disease. […] Underlying systemic conditions are found in up to 50% of cases and so it is imperative to try and identify such conditions once a diagnosis of PG has been made. […] Despite being a well-recognised condition, there is often a failure to make an early diagnosis of PG. It is important for all clinicians to be aware of this condition and to actively consider PG when assessing patients with ulcers, as appropriate and prompt treatment at an early stage of the disease may avoid the complications of prolonged systemic treatment, delayed wound healing and scarring.

• #103 Pyoderma Gangrenosum Causes, Treatments, & Misdiagnosis

  https://www.epiphanydermatology.com/medical-dermatology/pyoderma-gangrenosum-treatment/

  Pyoderma gangrenosum (PG) is a rare ulcerating skin disease, difficult to recognize for both patients and doctors. […] The most common type of PG is Ulcerated PG. In these cases, a small pustule (or pus bump) appears on the lower leg (and can be on other sites). Within a few days, this puss bump becomes very painful and begins to rapidly ulcerate. It will appear to have a purple border that overhangs the ulceration. We call this the violatious undermined border or overhanging border. […] Ulcerative pyoderma gangrenosum causes extremely painful ulcerations. […] In postoperative pyoderma gangrenosum, the PG ulcerations are often mistaken for an infection at the surgery site. […] A unique characteristic of PG in the breast is that it often spares the nipple/areolar complex and ulcerates around the incisions and spreads outwards.

• #104 Pyoderma gangrenosum – Wikipedia

  https://en.wikipedia.org/wiki/Pyoderma_gangrenosum

  Pyoderma gangrenosum is a rare, inflammatory skin disease where painful pustules or nodules become ulcers that progressively grow. […] The disease was identified in 1930. It affects approximately 1 person in 100,000 in the population. Though it can affect people of any age, it mostly affects people in their 40s and 50s. […] One hallmark of pyoderma gangrenosum is pathergy, which is the appearance of new lesions at sites of trauma, including surgical wounds. […] Diagnosis of PG is challenging owing to its variable presentation, clinical overlap with other conditions, association with several systemic diseases, and absence of defining histopathologic or laboratory findings. Misdiagnosis and delayed diagnosis are common. It has been shown that up to 39% of patients who initially received a diagnosis of PG have an alternative diagnosis. […] First-line therapy for disseminated or localized instances of pyoderma gangrenosum is systemic treatment with corticosteroids and ciclosporin.

• #105 Pyoderma Gangrenosum Causes, Treatments, & Misdiagnosis

  https://www.epiphanydermatology.com/medical-dermatology/pyoderma-gangrenosum-treatment/

  Most patients may see several physicians until the disorder is correctly diagnosed. […] Pyoderma gangrenosum treatment is extremely different from treating the illnesses it mimics. Typically, treating PG requires a high-dose systemic corticosteroid or immunomodulating medications such as cyclosporine or the biologics instead of debridement, which makes the issue worse. […] Once treatment is initiated, PG ulcers can begin to heal in days, especially decreasing the pain, and the lesions may shrink over weeks to months, leaving a star-like scar. […] It may, unfortunately, return in the same and other sites with the flare of a systemic disorder or trauma.

• #106 Pyoderma Gangrenosum – Skin Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/skin-disorders/hypersensitivity-and-reactive-skin-disorders/pyoderma-gangrenosum

  Pyoderma gangrenosum is a chronic inflammatory skin disorder of unknown cause that causes large sores on the skin. […] This disorder begins as small bumps or blisters that become open sores. […] Most often, pyoderma gangrenosum begins as a red bump that may resemble a pimple or an insect bite. Less often, it begins as a blister. The bump or blister then becomes an open, painful sore (ulcer) that expands rapidly. The sores have a raised border that is dusky or purple. The sores can grow together to form larger sores. People often are left with scars after sores heal. […] People commonly have fever and a general feeling of illness (malaise). […] Pyoderma gangrenosum can also develop at other locations, such as in the abdominal wall around a colostomy or ileostomy opening in people who have inflammatory bowel disease, or on the genitals or buttocks. In some people with pyoderma gangrenosum, areas other than the skin, such as the bones, lungs, heart, liver, or muscles, are affected. […] The diagnosis of pyoderma gangrenosum is strongly suggested if the sores worsen after minor trauma or a surgical procedure (such as a skin biopsy). […] Cyclosporine can be very effective, particularly for people whose disease is progressing rapidly.

• #107 Pyoderma Gangrenosum: A Diagnostic Challenge for the Surgical Consultant | ACS

  https://www.facs.org/for-medical-professionals/news-publications/journals/case-reviews/issues/v4n1/harrington-pyoderma-gangrenosum/

  PG is a neutrophilic dermatosis representing the second most common dermatological extraintestinal manifestation of inflammatory bowel disease (IBD). […] Ulcerative disease is most common, characterized by necrolytic cutaneous ulcers with violaceous and irregular borders. […] PG wounds have been described to occur in any location on the body, including the torso, back, face, perianal area, and extremities. […] Diagnosis of PG was one of exclusion; however, in 2018, a panel of experts released a Delphi consensus of diagnostic criteria consisting of one major and eight minor criteria. […] Treatment of PG focuses on reducing ongoing inflammation, limiting pain, and preventing infection and often includes a mix of wound care, topical therapies, and systemic immunosuppressive therapies.

• #108 Pyoderma Gangrenosum – Skin Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/skin-disorders/hypersensitivity-and-reactive-skin-disorders/pyoderma-gangrenosum

  Pyoderma gangrenosum is a chronic inflammatory skin disorder of unknown cause that causes large sores on the skin. […] This disorder begins as small bumps or blisters that become open sores. […] Most often, pyoderma gangrenosum begins as a red bump that may resemble a pimple or an insect bite. Less often, it begins as a blister. The bump or blister then becomes an open, painful sore (ulcer) that expands rapidly. The sores have a raised border that is dusky or purple. The sores can grow together to form larger sores. People often are left with scars after sores heal. […] People commonly have fever and a general feeling of illness (malaise). […] Pyoderma gangrenosum can also develop at other locations, such as in the abdominal wall around a colostomy or ileostomy opening in people who have inflammatory bowel disease, or on the genitals or buttocks. In some people with pyoderma gangrenosum, areas other than the skin, such as the bones, lungs, heart, liver, or muscles, are affected. […] The diagnosis of pyoderma gangrenosum is strongly suggested if the sores worsen after minor trauma or a surgical procedure (such as a skin biopsy). […] Cyclosporine can be very effective, particularly for people whose disease is progressing rapidly.

• #109 Pyoderma gangrenosum – a guide to diagnosis and management 

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6542232/

  This is an important but rare clinical variant that presents with destructive ulceration typically affecting the upper torso, head and neck. Lesions do not display the violaceous edge seen in classical PG and the condition is not associated with systemic disease. […] Underlying systemic conditions are found in up to 50% of cases and so it is imperative to try and identify such conditions once a diagnosis of PG has been made. […] Despite being a well-recognised condition, there is often a failure to make an early diagnosis of PG. It is important for all clinicians to be aware of this condition and to actively consider PG when assessing patients with ulcers, as appropriate and prompt treatment at an early stage of the disease may avoid the complications of prolonged systemic treatment, delayed wound healing and scarring.

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