Pyoderma gangrenosum

Question 1

Pyoderma gangrenosum

Answer 1

• rare, non-infectious, inflammatory disorder
• uncommon cause of very painful skin ulceration
• lower legs most common site

Question 2

Pathophysiology of pyoderma gangrenosum

Answer 2

• classified as a neutrophilic dermatosis
• ^^ skin conditions characterised by dense infiltration of neutrophils in affected tissue

Question 3

Causes of pyoderma gangrenosum

Answer 3

• idiopathic (~50%)
• IBD (10-15%)
• rheumatic
• haematological

Question 4

Features of pyoderma gangrenosum

Answer 4

• typically on lower limb
• starts suddenly, small pustule/red bump/blood-blister
• skin breaks down -> ulcer (painful)
• ulcer -> deep and necrotic
• may have systemic symptoms - fever myalgia

Question 5

Diagnosing pyoderma gangrenosum

Answer 5

• from characteristic appearance, associated disease, exaggerated skin injury following minor trauma

Question 6

Management of pyoderma gangrenosum

Answer 6

• oral steroids first line (due to rapid progression)
• immunosuppressive therapy (e.g. ciclosporin) (difficult cases)