Pathophysiology of pyoderma gangrenosum (PG): An updated review

Braswell, Sara F.; Kostopoulos, Tassia C.; Ortega‐Loayza, Alex G.

doi:10.1016/j.jaad.2015.06.021

Cited by 216 publications

(233 citation statements)

References 86 publications

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“…PG is a diagnosis of exclusion and recognizing PG can be very challenging [6,7]. There are no definitive tests, and excluding other causes almost always requires a skin biopsy and tissue culture.…”

Section: Resultsmentioning

confidence: 99%

Old but Gold: The Importance of Medical History in Diagnosing Neutrophilic Dermatoses Characterized by Pathergy. A Case of Pyoderma Gangrenosum

Paganelli¹,

Garbarino²,

Fiorentini³

et al. 2017

J Clin Exp Dermatol Res

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We describe the case of an 84-years old woman referred to our clinic without an established diagnosis in 2015 for the presence of multiple cervical ulcers since 2013, when she underwent vascular surgery of the carotid arteries. The ulcers had infiltrated and actively inflamed violaceous borders; they were itchy and showed signs of scratching. The patient had already been prescribed different antibiotic treatments, without any clinical improvement. Multiple biopsies had also been performed, but histology was not diagnostic, showing a non-specific dermal inflammatory infiltrate. Despite optimal wound care treatment, we observed a dramatic worsening of the skin lesions, spreading from the neck to the vertex, especially at sites of minor trauma (for example, starting from scratch lesions). The presence of pathergy, which consists in the occurrence of lesions at sites of trauma, suggested the diagnosis of pyoderma gangrenosum. Systemic glucocorticoid therapy was then prescribed, with quick improvement and nearly completes clinical remission. Our case confirms the importance of anamnesis and detailed collection of symptoms associated with the clinical manifestations in dermatological dermatoses such as pyoderma gangrenosum where imaging, histology and laboratory findings are often not very helpful for a correct diagnosis.

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Section: Resultsmentioning

confidence: 99%

Old but Gold: The Importance of Medical History in Diagnosing Neutrophilic Dermatoses Characterized by Pathergy. A Case of Pyoderma Gangrenosum

Paganelli¹,

Garbarino²,

Fiorentini³

et al. 2017

J Clin Exp Dermatol Res

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“…O pioderma gangrenoso é uma dermatose neutrofílica incomum, de curso crónico-recidivante, cuja etiopatogenia é provavelmente multifactorial. [1][2][3] Surge frequentemente (50% -70%) associado a doenças sistémicas, 1-3 nomeadamente doenças inflamatórias intestinais, 4,5 artrites e neoplasias hematológicas. O diagnóstico precoce é fundamental e implica reconhecer as manifestações clínicas sugestivas, excluir outras causas de ulceração e pesquisar eventuais associações.…”

Section: Imagens Médicasunclassified

“…O diagnóstico precoce é fundamental e implica reconhecer as manifestações clínicas sugestivas, excluir outras causas de ulceração e pesquisar eventuais associações. [1][2][3] O tratamento é feito com fármacos imunossupressores. Um homem de 55 anos, com colite ulcerosa não controlada, foi observado por extensa úlcera dolorosa na perna direita, rapidamente progressiva em quatro semanas, com bordo violáceo irregular, elevado e descolado, e fundo necrótico e sangrante (Fig.…”

Section: Imagens Médicasunclassified

Pioderma Gangrenoso em Doente com Colite Ulcerosa

Coelho

Fernandes

2018

Acta Med Port

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“…Vasculitis was observed in one biopsied specimen [10]. However, it is suggested that the presence of vasculitis is secondary to heavy inflammation and is not a direct consequence of PG [8]. Perivascular hyalinization, fibrin deposition, hemorrhage and leukocytoclasia can be present in some lesions [12].…”

Section: Histopathologymentioning

confidence: 99%

“…Some cases of cutaneous PG, sometimes accompanied by oral lesions, have been observed in patients with chronic hepatitis [36], acute or chronic leukemia [2,8,9,33,35], polycythemia rubra vera [10,25] and refractory anemia [17]. PG was the initial manifestation of leukemia in some cases [35].…”

Section: Underlying Systemic Diseases Associated With Pgmentioning

confidence: 99%