Pyoderma Gangrenosum Flashcards
what is pyoderma gangrenosum?
rare, non-infectious, inflammatory disorder
what is the most common site for pyoderma gangrenosum?
- lower legs
- soften at the site of a minor injury = pathergy
what is the pathophysiology of pyoderma gangrenosum?
neutrophilic dermatosis
* characterised by dense infiltration of neutrophils in the affected tissue
what are the most common cause of pyoderma gangrenosum?
idiopathic in 50%
what GI conditions are associated with pyoderma gangrenosum?
inflammatory bowel disease:
* ulcerative colitis
* crohn’s disease
what rheumatological conditions are assocaited with pyoderma gangrenosum?
- rheumatoid arthritis
- SLE
what haematological conditions are associated with pyoderma gangrenosum?
- myeloproliferative disorders
- lymphoma
- myeloid leukaemias
- monoclonal gammopathy (IgA)
what are the causes of pyoderma gangrenosum?
- idiopathic
- IBD
- rheumatological
- haematological
- granulomatosis with polyangiitis
- primary biliary cirrhosis
what are the initial features of pyoderma gangrenosum?
- usually starts quite suddenly
- small pustule, red bump or blood-blister
what are the later features of pyoderma gangrenosum?
- skin breaks down resulting in an ulcer which is often painful
- ulcer itself may be deep and necrotic
- accompanied by systemic symptoms - fever, myalgia
how is pyoderma gangrenosum diagnosed?
- clinical presentation and history
- histology - rule out other causes of ulcer
what is the management of pyoderma gangrenosum?
- oral steroids
- difficult cases = ciclosporin or infliximab
- surgery postponed until disease progress is controlled
