Pyoderma gangrenosum (gangrenous dermatitis) is a dermatological disease characterized by sunken ulcers. The reasons for its appearance are not fully known, but it is known that it may appear as a result of systemic diseases. What are the symptoms of pyoderma gangrenosum and how is it treated?

Pyoderma gangraenosum( pyoderma gangraenosum ) is a rare skin disease characterized by sunken sores that form suddenly. Despite its name, pyoderma gangrenosum is not related to bacterial infection, but is due to necrosis of the vascular walls.

Pyoderma gangrenosum is most often diagnosed in people between 25 and 54 years of age, although it can also develop in childhood.

The disease may appear alone or accompany systemic diseases such as:

  • ulcerative colitis
  • Crohn's disease
  • arthritis
  • multiple myeloma
  • leukemia
  • chronic active hepatitis
  • sometimes occurs as a paraneoplastic syndrome

The cause of the disease is unknown.

Pyoderma gangrenosum: types

The classification includes four main varieties of pyoderma:

  • ulcerative pyoderma- can accompany inflammatory bowel diseases and monoclonal gammapathies, it mainly affects the torso and legs, which does not mean that it will not occur on the head (also under the hair) or on the neck or penis, the lesions take the form of ulcers with turned, blue edges around which an inflammatory ring develops
  • Pustular pyoderma- often occurs in exacerbations of ulcerative colitis, small spots appear on the unchanged skin of the extensor parts and on the upper half of the body, and are surrounded by inflammatory erythema
  • bullous pyoderma- most often accompanies myeloproliferative diseases, when it occurs in the course of leukemia, it significantly worsens the prognosis; takes the form of superficial, painful blisters with an erythematous areola, gradually turning into erosions and ulcers
  • rocking pyoderma- limited form with a chronic course, usually occurs alone (does not accompany systemic diseases),superficial, shallow, painless ulcers with slow progression usually appear on the trunk

Pyoderma gangrenosum: symptoms

Typical for this condition are:

  • skin abnormalities in the form of deep and well-demarcated ulcers
  • changes spread dynamically, sometimes their formation is preceded by an inflammatory infiltrate or development of reactive blisters
  • skin eruptions are single or multiple
  • some changes may heal and new ones may arise at the same time
  • the course of pyoderma is chronic and progressive

Pyoderma gangrenosum: diagnosis

The diagnosis of the disease is based on the finding of sudden, recessed and rapidly spreading skin lesions in the form of ulcers.

In addition, detailed tests for ulcerative colitis and proliferative changes in the hematological system are performed.

Pyoderma gangrenosum: treatment

Treatment of this disease should begin with administration of sulfones and salazosulfapyridine. The beneficial effects are obtained after combining these preparations with low doses of glucocorticosteroids, e.g. prednisone.

Good results are also observed after conducting pulse therapy with glucocorticosteroids (administering the so-called mega-doses of preparations for some time) and maintaining the treatment with chlorambucil and small amounts of glucocorticosteroids (continuation of therapy).

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Category:

Dermatology