Prevalence estimates for pyoderma gangrenosum in the United States: An age- and sex-adjusted population analysis

Recent advances in managing and understanding pyoderma gangrenosum

“…Pyoderma gangrenosum (PG) is a rare auto-inflammatory ulcerative dermatosis with an overall incidence of 5.8 per 100,000 individuals and an increased mortality rate when compared with the general population 1, 2 . However, given the lack of gold standard for diagnosis, the exact prevalence has yet to be elucidated since PG is commonly under- and over-diagnosed.…”

The great imitator with no diagnostic test: pyoderma gangrenosum

“…3,9 It affects individuals of all ages, with an average of onset at 59 years old, 10 affecting predominantly female (68%), and Caucasian patients (78.5%). 2,9,11 Approximately 50% of patients have associated medical condition, as inflammatory bowel diseases (IBD), haematological malignancies (IgA monoclonal gammopathies, acute myelogenous leukaemia, myelodysplasia), solid malignancies and rheumatological disorders (Sjögren's disease, ankylosing spondylitis, lupus erythematosus). 3,8,9,11,12 Patients with PG who have an underlying hematologic cancer, dyscrasia, and vasculitis have worse hospital outcomes than do patients with inflammatory bowel disease or inflammatory arthritis.…”

“…17 Oestrogen receptors are expressed on T cells, B cells, dendritic cells, neutrophils, macrophages, and NK cells. 11,18 4 | CLINICAL FEATURES There are five clinical subtypes of PG (Figures 1 to 5), which are summarised in Table 1. 2,[8][9][10]19 Granulomatous superficial or vegetative PG, affects more frequently the trunk and characteristically begin as a single furunculoid purple abscess, nodule, or plaque that evolve more slowly into an ulcer in association with sinuses and cribriform scarring, most commonly on the trunk.…”

“…It is important to think in PG as a differential diagnosis, because delays in diagnosis frequently expose patients to multiple diseaseexacerbating debridement, unnecessary antibiotics or other inappropriate therapies. 11,21 There are no universally accepted or validated criteria to diagnose PG.…”

“…• Pyoderma gangrenosum is a rare, chronic, rapidly evolving cutaneous ulcers, of unknown aetiology, diagnosed by exclusion of infection, neoplasia, thrombophilia, and other inflammatory conditions [1][2][3] • Pyoderma gangrenosum belongs to the group of neutrophil-mediated skin diseases, in which there is an altered neutrophil recruitment and activation in the skin, and is the hallmark of a heterogenous group of polymorphic cutaneous manifestations 4,11 • Pyoderma gangrenosum can mimic other cutaneous conditions that cause skin ulceration, like bacterial infections, vascular occlusive disease, haematological causes (sickle cell disease, cryoglobulinemia, and anti-phospholipid syndrome), calciphylaxis, drug-induced ulceration, chronic non-healing wounds, and other inflammatory conditions (Table 2) and targeted laboratory testing based on history and physical exam. 10 Gastrointestinal evaluation with a colonoscopy should be strongly considered given the strong association with IBD.…”