The great imitator with no diagnostic test: pyoderma gangrenosum

Abstract

Pyoderma gangrenosum is a rare, neutrophil‐mediated, auto‐inflammatory dermatosis that wound care specialists must be prepared to recognise. This condition has clinical features analogous to infectious processes. There is no specific diagnostic test and the diagnosis is usually obtained from exclusion. Its early recognition and proper management with prompt initiation of immunosuppressive therapy are essential to improve the quality of life and the prognosis of patients.

A Case Report of Extensive Pyoderma Gangrenosum on the Upper Third of the Body

“…Approximately 50% of the PG cases are accompanied by systemic diseases such as inflammatory bowel disease, arthritis, solid malignancies, hematological malignancies, HIV, and rheumatological disorders. 5,13,14 In this report, the patient had initial lesions in the form of pustules that enlarged into nodules, then ruptured to became tender ulcers with uneven edges. We observed hemorrhagic crusts covering the granulation tissue at the base of the wound on the right-side of the forehead, temples, cheeks, occipital region of the scalp, neck, shoulder, upper chest, and back.…”

“…2,9 The incidence is estimated at around 3-10 cases per million population per year. 5,6 Initial PG lesions can be in the form 1646 painful pustules, nodules, or plaques. 1,2 Within a few days, the skin lesions may enlarge and rupture to form well-defined ulcers, with irregular violaceous edges.…”

“…3 Based on the clinical manifestation, PG is classified into five subtypes: peristomal, pustular, bullous, vegetative, or classic (ulcerative). 4,5 The lower extremity is the most common predilection site for PG. 1,6 However, it can also occur on other sites of the body, including the trunk, upper extremities, head, and neck.…”

Pyoderma Gangrenosum: An Ulcer With Unorthodox Treatment

“…During the regression of PG, the border of the lesion's collapses, erythema fades and granulation tissue appears on the ulcer. After healing, atrophic, cribriform scars persist [8].…”

Patologías cutáneas asociadas a gammapatías monoclonales: ¿qué sabemos hasta ahora?

“…En varias patologías cutáneas asociadas a GMs el mecanismo fisiopatológico aún no ha sido dilucidado 5,6 . Resumimos las diferentes dermopatías con su respectiva asociación en la Tabla 2 [45][46][47][48] .…”