Pyoderma gangrenosum is an ulcerating skin disease.
Presentation:
- A deep violet-blue ulcer with a well-defined, undermined edge
- Can occur anywhere but is most common on the legs
- Usually painful
- Systemic symptoms – fever, arthralgia, malaise
It is a neutrophillic dermatoses, like Sweet’s syndrome
Around half of cases of pyoderma gangrenosum are idiopathic.
The other half may be associated with:
- Inflammatory bowel disease – commonest association
- Overall 2% of patients with IBD will have pyoderma gangrenosum
- Arthritis
- Haematological malignancies
- Myeloid > lymphoid, AML most commonly
- myeloproliferative disorders
- myeloma
- Sarcoidosis
- Wegeners granuomatosis
- Diabetes mellitus
- Behcet’s disease
Diagnosis
- Pyoderma gangrenosum is a clinical diagnosis
- Biopsy may be undertaken to exclude other diagnoses, such as malignancy or vasculitis
Treatment
Currently a lack of definitive evidence but in general systemic steroids or ciclosporin are used.
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