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Indian Journal of Dermatology,... 2017Pyoderma gangrenosum is a neutrophilic dermatosis of unknown etiology, with inconstant systemic associations and a variable prognosis.
BACKGROUND
Pyoderma gangrenosum is a neutrophilic dermatosis of unknown etiology, with inconstant systemic associations and a variable prognosis.
AIMS
To study the clinical features and systemic associations of pyoderma gangrenosum and its response to treatment.
METHODS
All patients diagnosed to have pyoderma gangrenosum at the dermatology department of the Government Medical College, Kozhikode, from January 01, 2005 to December 31, 2014 were included in this prospective study.
RESULTS
During the 10-year study period, 61 patients were diagnosed to have pyoderma gangrenosum. A male predilection was noted. The most common clinical type was ulcerative pyoderma gangrenosum (90.2%). More than 60% of patients had lesions confined to the legs; 78.7% had a single lesion and 27.9% had systemic associations. Most patients required systemic steroids. Patients with disease resistant to steroid therapy were treated with intravenous immunoglobulin G and split-thickness skin grafts under immunosuppression induced by dexamethasone pulse therapy. All except one patient attained complete disease resolution.
LIMITATIONS
The main limitation of our study was the small sample size.
CONCLUSIONS
The male predilection documented by us was contrary to most previous studies. We found split-thickness skin graft to be a useful option in resistant cases. More prospective studies may enable the formulation of better diagnostic criteria for pyoderma gangrenosum and improve its management.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Humans; Immunoglobulins, Intravenous; Infant; Male; Middle Aged; Prospective Studies; Pyoderma Gangrenosum; Sex Factors; Skin Transplantation; Young Adult
PubMed: 27549869
DOI: 10.4103/0378-6323.188654 -
JPMA. the Journal of the Pakistan... Jan 2022Pyoderma Gangrenosum (PG) is a rare, debilitating, and painful disease of the skin. Its aetiology and pathophysiology are not well understood. However, it is known that... (Review)
Review
Pyoderma Gangrenosum (PG) is a rare, debilitating, and painful disease of the skin. Its aetiology and pathophysiology are not well understood. However, it is known that PG is not bacterial in origin, as previously believed. A significant number of cases of PG report a phenomenon called pathergy, which is characterized by the appearance of new lesions after the application of trauma to the skin. This represents a unique challenge for surgeons in cases that are refractory to medical therapy. The objective of this study is to review past literature and report a case of PG in a 19-year old woman, who presented with recurrence, after undergoing skin grafting one year back. The patient was referred for split thickness skin grafting (STSG) to reduce the psychological and physical morbidity as a result of this disease.
Topics: Adult; Female; Humans; Pyoderma Gangrenosum; Skin; Skin Transplantation; Young Adult
PubMed: 35099456
DOI: 10.47391/JPMA.11-1109 -
Acta Dermatovenerologica Alpina,... Mar 2022Pyoderma gangrenosum is an uncommon neutrophilic dermatosis that usually presents with rapidly growing, painful, undermined, and purulent ulcers that are more likely to... (Review)
Review
Pyoderma gangrenosum is an uncommon neutrophilic dermatosis that usually presents with rapidly growing, painful, undermined, and purulent ulcers that are more likely to develop at areas of trauma. It is associated with underlying systemic diseases in more than half of cases, most commonly with inflammatory bowel disease. Pyoderma gangrenosum has no specific clinical, histologic, or laboratory findings, and so the diagnosis is based on exclusion of all other diagnostic possibilities, especially infectious causes. Misdiagnoses are frequent, with systemic vasculitides representing one of the main imitators. Treatment of pyoderma gangrenosum usually requires a multidisciplinary approach, with infliximab emerging as the best treatment option for cases associated with inflammatory bowel disease. The prognosis of pyoderma gangrenosum remains unpredictable, and recurrences are common. Here, we report a case of mucocutaneous pyoderma gangrenosum as a preceding sign of ulcerative colitis that responded to treatment with methylprednisolone and infliximab.
Topics: Colitis, Ulcerative; Humans; Pyoderma Gangrenosum
PubMed: 35339135
DOI: No ID Found -
BMJ (Clinical Research Ed.) Jul 2006
Review
Topics: Biopsy; Early Diagnosis; Humans; Immunosuppressive Agents; Pyoderma Gangrenosum; Skin
PubMed: 16858047
DOI: 10.1136/bmj.333.7560.181 -
International Wound Journal Dec 2022
Topics: Humans; Pyoderma; Pyoderma Gangrenosum
PubMed: 35560865
DOI: 10.1111/iwj.13828 -
Clinics in Dermatology 2021Neutrophilic dermatoses (NDs) are a group of reactive, noninfectious autoinflammatory diseases characterized by (1) infiltration of the epidermis, dermis, and... (Review)
Review
Neutrophilic dermatoses (NDs) are a group of reactive, noninfectious autoinflammatory diseases characterized by (1) infiltration of the epidermis, dermis, and or/hypodermis by neutrophils; (2) their association with distinct diseases (eg, hematologic malignancy and chronic inflammatory diseases); (3) potential extracutaneous involvement; and (4) response to anti-inflammatory drugs, such as corticosteroids, dapsone, colchicine, and novel biologic therapies, such as the anti-interleukin-1 blockade. Although distinct NDs have been described, transitional forms with overlapping features are often identified. These justify a simplified classification of NDs with three major forms: superficial (epidermal or pustular) NDs, dermal (en plaques) NDs, and deep NDs. We review selected or novel variants of NDs, including subcorneal pustular dermatosis, the group of immunoglobulin A neutrophilic dermatoses, amicrobial pustular dermatosis of the folds, and neutrophilic urticarial dermatosis, as well as atypical forms of Sweet syndrome and pyoderma gangrenosum closely mimicking severe infectious diseases. Knowledge of these variants is essential for proper diagnosis, adequate management, and avoidance of a dangerous escalation of therapy, such as unnecessary immunosuppression or extensive surgery.
Topics: Anti-Inflammatory Agents; Dermatitis; Humans; Neutrophils; Pyoderma Gangrenosum; Skin Diseases, Vesiculobullous; Sweet Syndrome
PubMed: 34272020
DOI: 10.1016/j.clindermatol.2020.10.012 -
Postepy Higieny I Medycyny... Mar 2016Pyoderma gangrenosum (PG) is caused by immune system dysfunction, and particularly improper functioning of neutrophils. At least half of all PG patients also suffer from... (Review)
Review
BACKGROUND
Pyoderma gangrenosum (PG) is caused by immune system dysfunction, and particularly improper functioning of neutrophils. At least half of all PG patients also suffer from autoimmunological diseases, one of which is Wegener granulomatosis (WG). The purpose of this article was to compare cases of patients with WG and PG in terms of their clinical course, histopathology, and applied treatment. In both, histopathological features are not fully distinct. Data from microbiological and immunological evaluation and clinical presentation are required to establish the diagnosis. We also present the case of a patient with WG and deep facial skin lesions not responding to standard treatment.
METHODS
Systematic review of the literature in PubMed using the search terms "Wegener granulomatosis AND Pyoderma gangrenosum" and case report.
RESULTS
The finding of 22 reports in the literature (PubMed) suggests that it is a rare phenomenon. This study revealed a similar rate of comorbidity of WG and PG in both genders and an increased incidence of both diseases after the age of 50. Among skin lesions there was a dominance of ulceration, most often deep and painful, covering a large area with the presence of advanced necrosis and destruction of the surrounding tissue. The most common location proved to be the cervical-cephalic area. The most popular treatment included steroids with cyclophosphamide.
DISCUSSION
The rarity of the coexistence of these two diseases results in a lack of effective therapy. In such cases sulfone derivatives are still effective and provide an alternative to standard immunosuppression methods. Hyperbaric therapy and plasmapheresis can also play an important complementary role.
Topics: Face; Female; Granulomatosis with Polyangiitis; Humans; Neck; Necrosis; Neutrophils; Pyoderma Gangrenosum; Skin Ulcer; Young Adult
PubMed: 27117096
DOI: 10.5604/17322693.1197372 -
Clinics in Dermatology 2023
Topics: Humans; Pyoderma Gangrenosum; COVID-19; Vaccination
PubMed: 36442730
DOI: 10.1016/j.clindermatol.2022.11.003 -
Journal of Applied Microbiology Feb 2017Pyoderma, predominantly associated with Staphylococcus pseudintermedius, is a common skin infection of dogs that typically requires long-lasting treatments, complicated...
AIMS
Pyoderma, predominantly associated with Staphylococcus pseudintermedius, is a common skin infection of dogs that typically requires long-lasting treatments, complicated by increasing antimicrobial resistance. To investigate new treatment strategies, we aimed at establishing a dog model of pyoderma that closely mimics the natural disease.
METHODS AND RESULTS
We inoculated six laboratory beagles with a methicillin-susceptible strain of S. pseudintermedius. One millilitre of approximately 10 , 10 , 10 CFU per ml was topically applied onto clipped and tape stripped area of dog skin, which was then treated with a dermaroller (microneedle size: 500 μm) immediately after administration. Dogs were monitored daily, suspect pustules were cultured for S. pseudintermedius and evaluated by cytological and histopathological methods. After 24 h, all dogs developed papules and pustules at all three bacterial inoculation sites, which worsened over the next 48 h. Cytological samples of all skin lesions revealed neutrophils with intracellular cocci. Histopathology confirmed subcorneal neutrophilic pustular dermatitis with intralesional cocci and acantholytic keratinocytes, consistent with superficial pyoderma. Staphylococcus pseudintermedius was isolated from pustules of all dogs and confirmed to be the inoculating strain. The results were replicated in all dogs after a wash out period of 6 weeks.
CONCLUSIONS
These data demonstrate the feasibility of establishing a dog model of pyoderma.
SIGNIFICANCE AND IMPACT OF THE STUDY
The new model can be used to evaluate novel prevention and treatment options for canine pyoderma.
Topics: Animals; Dermatitis, Atopic; Disease Models, Animal; Dog Diseases; Dogs; Female; Male; Pyoderma; Staphylococcal Skin Infections; Staphylococcus
PubMed: 27891724
DOI: 10.1111/jam.13362 -
BMJ (Clinical Research Ed.) Oct 1991
Topics: Humans; Pyoderma; Scalp Dermatoses; Skin Ulcer
PubMed: 1933018
DOI: 10.1136/bmj.303.6807.925-a