Pyoderma gangrenosum

Question 1

is pyoderma infectious ?

Answer 1

no
non-infectious, inflammatory disorder

Question 2

common site for pyoderma gangrenosum?

Answer 2

may affect any part of the skin, but the lower legs are the most common site. (SHINS)

Question 3

pyoderma gangrenosum is classified as a

Answer 3

neutrophilic dermatosis -characterised by dense infiltration of neutrophils often seen on biopsy

Question 4

causes of pyoderma gangrenosum?

Answer 4

diopathic in 50%

inflammatory bowel disease in 10-15%
ulcerative colitis
Crohn’s

rheumatological
rheumatoid arthritis
SLE

Question 5

initially features of pyoderma gangrenosum?

Answer 5

starts quite suddenly

small pustule, red bump or blood-blister

Question 6

later
features of pyoderma gangrenosum?

Answer 6

ulcer which is often painful

edge of the ulcer is often described as purple, violaceous and undermined

ulcer itself may be deep and necrotic

maybe accompanied by fever

Question 7

diagnosis of pyoderma gangrenosum ?

Answer 7

made by the characteristic appearance,

associations with other diseases,

the presence of pathergy,

histology results and when other diseases have been ruled out

histology is not specific and can vary depending on the time and site of the specimen but may be helpful in ruling out other causes of an ulcer

Question 8

first line management of pyoderma gangrenosum ?

Answer 8

otential for rapid progression is high = prednisolone oral steroids

Question 9

second line ?

Answer 9

ciclosporin and infliximab, have a role in difficult cases

Question 10

surgery in pyoderma gangrenosum should be postponed until?

Answer 10

disease process is controlled on immunosuppression