Pyoderma Gangrenosum
What is Pyoderma Gangrenosum?
Pyoderma gangrenosum (PG) is a rare skin disorder that results in painful sores and ulcers. It usually begins as one or more small pimple-like bumps, which can quickly progress to develop into a large ulcer, sometimes with an undercut border. The cause of PG is unknown, but doctors believe it is the body’s abnormal immune response to an infection or injury. PG is more common in people with certain diseases, such as inflammatory bowel disease (IBD), arthritis, or immune-mediated disorders.
Signs and Symptoms:
- Skin pain and tenderness, sometimes in the absence of an ulcer
- Small red, raised bumps which quickly evolve into crater-like ulcers
- Undercut borders or raised edges around ulcers
- Swelling of the skin
- Blisters
- Itchy skin
- Fever
- Malodorous discharge from the ulcer
Diagnosis
Pyoderma gangrenosum is often difficult to diagnose due to its rarity and similarity to other skin disorders. If you have signs or symptoms that may suggest PG, your doctor may take a biopsy of the affected skin to look for certain features that are unique to PG. These features are characteristic of PG and can usually help to accurately diagnose the condition. Your doctor may also recommend blood tests and imaging devices, such as X-rays or ultrasound, to look for any underlying conditions that may be contributing to the PG.
Treatment
Treatments for pyoderma gangrenosum depend on the underlying cause. In cases where the cause is unknown or where treatment of the underlying condition is not possible, treatment typically involves medications to suppress the immune system and limit inflammation. This includes corticosteroids, methotrexate, cyclosporine, and infliximab. If these medications are not effective, other treatments such as phototherapy, antibiotic creams, or immunosuppressants may be used. Surgery is rarely necessary but may be recommended if the ulcers do not respond to medications.
Prevention
Prevention of PG typically involves managing any underlying illnesses and treating them in order to reduce the risk of complications or flare-ups. It is also important to practice good skin hygiene to avoid any skin infections that may trigger the development of PG. In addition, it is important to avoid any unnecessary skin trauma, as this can increase the risk of developing PG.
