Pyoderma Gangrenosum and Leukemia

Tay, C. H.

doi:10.1001/archderm.1973.01620250060025

Cited by 47 publications

(17 citation statements)

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“…There are several lines of evidence supporting an immunologic etiology of PG. For one, as mentioned above, patients often have a coexisting immunemediated disease such as IBD or inflammatory arthritis (RA, ankylosing spondylitis, or other seronegative arthritis) (23)(24)(25)(26)(27)(28)(29)(30). Second, patients treated with immune modifying medications for other conditions rarely develop PG; for example, there have been separate case reports of patients developing PG in the setting of infliximab or granulocyte-macrophage colony-stimulating factor (GMCSF) therapy (31,32).…”

Section: Pathophysiologymentioning

confidence: 99%

Effective Strategies for the Management of Pyoderma Gangrenosum: A Comprehensive Review

Patel¹,

Fitzmaurice²,

Duong³

et al. 2015

Acta Derm Venerol

106

115

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Pyoderma gangrenosum (PG) is an inflammatory disease characterized by painful skin ulcerations with undermined and erythematous borders. The etiology of PG is not well understood, but it is generally considered to be an aberrant immune response characterized by a dermal neutrophilc infiltrate. Given the existence of only a few PG clinical trials, treatment options are largely based upon anecdotal data and small case studies. In addition to classic immunosuppressive medications, PG has been reported to respond well to the anti-TNF agents, infliximab, etanercept, adalimumab. Newer biologics such as ustekinumab (anti-IL-23), ixekizumab (anti-IL-17) and brodalumab (anti-IL-17R) are promising given the effect of IL-17 on neutrophil migration. However, the effectiveness of these newer agents remains to be rigorously evaluated. Multi-drug regimens have not been well described in the literature but are an excellent alternative for patients with refractory disease. Herein, we provide a comprehensive review of the pathophysiology of PG and of the different treatments available for managing PG patients, including the theoretical benefit of initiating multidrug regimens. We also provide one possible treatment algorithm for patients with refractory disease and give examples of refractory PG cases successfully treated with multidrug regimens.

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Section: Pathophysiologymentioning

confidence: 99%

Effective Strategies for the Management of Pyoderma Gangrenosum: A Comprehensive Review

Patel¹,

Fitzmaurice²,

Duong³

et al. 2015

Acta Derm Venerol

106

115

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“…P yoderma gangrenosum (PG) was once considered pathognomonic of idiopathic ulcerative colitis. It has since been described in association with a wide variety of disorders, 1,2 including Crohn's disease, arthritis, rheumatologic and hematologic conditions, 3,4 HIV infection, 5 sarcoidosis, 6 hereditary hypogammaglobulinemia, 7 iatrogenic immune suppression, 8 or malignancy. 1,2 The pathogenesis is unknown, but autoimmune mechanisms including immune complexemediated neutrophilic vascular reactions have been suggested.…”

mentioning

confidence: 99%

Treatment recommendations for pyoderma gangrenosum: An evidence-based review of the literature based on more than 350 patients

Reichrath

Bens

Bonowitz

et al. 2005

Journal of the American Academy of Dermatology

352

294

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“…Pyoderma gangraenosum ist in 50-70% der Fälle mit Systemkrankheiten assoziiert. Zu nennen sind insbesondere (modifiziert nach [16]): [4] F M. Crohn [17,18] Dys-und Paraproteinämien: F Monoklonale Gammopathien (meist IgA, ca. 10% der Fälle [9]) F Plasmozytom F Hypogammaglobulinämie [19] Myeloproliferative Erkrankungen [17,18]:…”

Section: äTiologie Und Pathogeneseunclassified

Management des Pyoderma gangraenosum

et al. 2010

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Pyoderma gangrenosum is a rare neutrophilic inflammatory skin disease, mostly observed in middle-aged adults. Etiology and pathogenesis remain unclear. Autoimmune mechanisms including immune complex-mediated neutrophilic vascular reactions have been suggested. The hallmark finding in pyoderma gangrenosum is painful ulcers with sharply circumscribed and demarcated, frequently undermined, livid borders and a necrotic base. Pyoderma gangrenosum has been described in association with a great variety of systemic disorders, ranging from inflammatory bowel diseases to myeloproliferative disorders. The diagnosis of pyoderma gangrenosum is based primarily on the clinical presentation and course. It is usually a diagnosis of exclusion. Histopathological and laboratory findings in pyoderma gangrenosum are nonspecific. The aims of therapy are the complete suppression of inflammatory disease activity, promotion of wound healing and control of pain. Frequently, successful treatment of associated diseases leads to an improvement or complete remission of pyoderma gangrenosum. Surgical interventions, including aggressive ulcer excision, recipient site preparation and autologous skin grafting have to be avoided during the active phase of the disease because the likely occurrence of pathergy inducing new lesions at surgical sites and causing a worsening the original lesions.

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Pyoderma Gangrenosum and Leukemia

Cited by 47 publications

References 0 publications

Effective Strategies for the Management of Pyoderma Gangrenosum: A Comprehensive Review

Effective Strategies for the Management of Pyoderma Gangrenosum: A Comprehensive Review

Treatment recommendations for pyoderma gangrenosum: An evidence-based review of the literature based on more than 350 patients

Management des Pyoderma gangraenosum

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