Pyoderma Gangrenosum: What Do We Know Now?

McKenzie, Fatima; Arthur, Megan; Ortega‐Loayza, Alex G.

doi:10.1007/s13671-018-0224-y

Cited by 13 publications

(34 citation statements)

References 135 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The relationship between external triggers (that is, pathergy) and genetic factors is poorly understood 5 . Pathergy has been suggested to be caused by increased activity of polymorphonuclear cells because of the presence of neutrophils in pathergic lesions of Behçet disease 7 .…”

Section: Pathophysiologymentioning

confidence: 99%

See 1 more Smart Citation

Recent advances in managing and understanding pyoderma gangrenosum

2019

View full text Add to dashboard Cite

Pyoderma Gangrenosum (PG) is a rare neutrophilic dermatosis with multiple different clinical presentations and associated comorbidities. PG has historically been a challenging disorder to diagnose, leading to the development of new diagnostic criteria rather than the traditional approach of a diagnosis of exclusion. The pathophysiology is thought to involve both innate and adaptive immune system dysregulation, neutrophilic abnormalities, environmental, and genetic factors. As of today, no gold standard therapy exists for the treatment of PG, and the literature is restricted to mainly case reports, case series, and 2 small randomized clinical trials. Topical, systemic, and biologic therapy, as well as adequate analgesia and proper wound care all play a role in the management of PG. Recent studies have identified additional cytokines and signalling cascades thought to be involved in the pathogenesis of PG, ultimately leading to the development of new targeted therapies. This review will focus on recent advances in the pathophysiology, clinical presentation and associated comorbidities, diagnosis, and management of PG.

show abstract

Section: Pathophysiologymentioning

confidence: 99%

“…PG is classified as a neutrophilic dermatosis because of a predominant neutrophilic inflammatory infiltrate in the lesions 3 . The pathophysiology of PG is not completely understood and is thought to be multifactorial, involving both the innate and adaptive immune system and having a genetic influence 4, 5 .…”

Section: Introductionmentioning

confidence: 99%

Recent advances in managing and understanding pyoderma gangrenosum

2019

View full text Add to dashboard Cite

show abstract

“…The pyoderma gangrenosum (PG), on the other hand, is a rare, rapidly progressive (except for the post‐surgical PG), autoinflammatory ulcerative skin and soft tissue condition. It affects approximately three to 10 patients per million . The precise aetiology remains unclear, but instability in the immune system, altered interleukin (IL) and tumour necrosis factor (TNF) release, and systemic inflammation under genetic predisposition are thought to be related to the pathogenesis of PG.…”

Section: Introductionmentioning

confidence: 99%

“…There are five different types of PG described in the literature; namely, bullous, pustular, ulcerative, vegetative, and atypical bullous types (Figure ) . The Delphi Consensus PG Diagnostic Criteria and the PARACELSUS Score are used to avoid misdiagnosis . A sterile incisional biopsy from the ulcer border including the subcutaneous tissue is required to rule out an infectious aetiology .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Necrotising fasciitis or pyoderma gangrenosum: A fatal dilemma

Demirdöver

Geyik

Vayvada

2019

International Wound Journal

View full text Add to dashboard Cite

Necrotising fasciitis (NF) is mostly a polymicrobial, severe soft tissue infection that progresses rapidly, penetrating through the subcutaneous tissue to the fascial planes and the muscles. The pyoderma gangrenosum (PG), on the other hand, is a rare, rapidly progressive (except for the post‐surgical PG), autoinflammatory ulcerative skin and soft tissue condition. In this study, we tried to emphasise the importance of diagnosing the NF as well as the PG. Although these two clinical presentations have some standard features, awareness of different symptoms in detail affect the outcome. Any surgical discipline can face NF or PG and, therefore, should be aware of them to decrease the mortality rate. Forty‐five patients with NF and PG who were treated between January 2008 and October 2018 were included in the study and evaluated retrospectively for age, sex, localisation, onset of symptoms and diagnosis, predisposing factors, characteristics of tissue defects, laboratory findings, Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) scores, isolated microbiological agents, surgical intervention, and mortality rate. Demographic, laboratory, and clinical data were analysed. Among these 45 patients, 14 patients had PG, and 31 patients had NF. The mean age and SD for the NF and PG groups were 50.80 ± 17.67 and 50.78 ± 12.72, respectively. Five patients had rheumatological disorders; four patients had diabetes mellitus (DM) in the PG group. Males had higher risk than females in NF (odds ratio [OR] = 0.077, 95% confidence interval [CI] 0.017‐0.34), and females had higher risk in PG (relative risk [RR] = 5). We compared the LRINEC score of NF patients with PG patients. The mean value of this score was 4.53 for PG patients, and 6.06 for NF patients. Fifteen patients (33.3%) had a radiological evaluation. MRI, CT, and USI were used as imaging modalities. Necrotising fasciitis and PG are two distinct entities that are in general difficult to distinguish. Therefore, differential diagnosis and rapid treatment are crucial for lowering the mortality rate.

show abstract

Wound Dressings – A Practical Review

Kus

Ruiz

2020

Curr Derm Rep

View full text Add to dashboard Cite

Pyoderma Gangrenosum: What Do We Know Now?

Cited by 13 publications

References 135 publications

Recent advances in managing and understanding pyoderma gangrenosum

Recent advances in managing and understanding pyoderma gangrenosum

Necrotising fasciitis or pyoderma gangrenosum: A fatal dilemma

Wound Dressings – A Practical Review

Contact Info

Product

Resources

About