Pyoderma gangrenosum
| Pyoderma gangrenosum | |
|---|---|
 |
|
| Pyoderma gangrenosum on the leg of a patient with Crohn's disease. | |
| Classification and external resources | |
| Specialty | dermatology |
| ICD-10 | L88 |
| ICD-9-CM | 686.01 |
| DiseasesDB | 11064 |
| eMedicine | article/1123821 |
| MeSH | D017511 |
Pyoderma gangrenosum is a condition that causes tissue to become necrotic, causing deep ulcers that usually occur on the legs. When they occur, they can lead to chronic wounds. Ulcers usually initially look like small bug bites or papules, and they progress to larger ulcers. Though the wounds rarely lead to death, they can cause pain and scarring.
The disease was identified in 1930. It affects approximately 1 person in 100,000 in the population. Though it can affect people of any age, it mostly affects people in their 40s and 50s.
There are two main types of pyoderma gangrenosum:
Other variations are:
Though the etiology is not well understood, the disease is thought to be due to immune system dysfunction, and particularly improper functioning of neutrophils. In support of an immune etiology, a variety of immune mediators such as IL-8, IL-1β, IL-6, interferon (IFN)-γ, G-CSF, TNF, matrix metallopaptidase (MMP)-9, MMP-10, and Elafin have all been reported to be elevated in patients with pyoderma gangrenosum.
Also in support of an immune etiology is the finding that at least half of all pyoderma gangrenosum patients suffer from immune-mediated diseases. For instance, ulcerative colitis, rheumatoid arthritis, and multiple myeloma (MM) have all been associated with pyoderma gangrenosum. It can also be part of a syndromes such as PAPA syndrome.
One hallmark of pyoderma gangrenosum is pathergy, which is the appearance of new lesions at sites of trauma.
The following are conditions commonly associated with pyoderma gangrenosum:
First-line therapy for disseminated or localized instances of pyoderma gangrenosum is systemic treatment by corticosteroids and ciclosporin. Topical application of clobetasol, mupirocin, and gentamicin alternated with tacrolimus can be effective.
...
Wikipedia