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Pyoderma

Pyoderma Fistulans Sinifica


Presentation

  • CONCLUSION: The present case underlines the fact that rare diseases might occasionally present with even more rare symptoms. These occasions can obviously be considered to present a considerable diagnostic challenge.[ncbi.nlm.nih.gov]
  • Herein we present a case of BLP arising in lichen planus, a chronic inflammatory disease.[ncbi.nlm.nih.gov]
  • The lesion had dramatically increased in size in the weeks prior to presentation. There was a history of Crohn's disease and ileal adenocarcinoma, both of which were in remission.[ncbi.nlm.nih.gov]
  • Nonperistomal pyoderma can present anywhere on the body, and case 4 ( Figures 4A-4C ) shows a case of pyoderma presenting on the hands.[woundsresearch.com]
  • Pathergy sign was present. Skin biopsy showed an aspect of neutrophilic dermatosis. ANA profile revealed positive anti-SSA/Ro and positive anti-SSB/La.[oatext.com]
Cushingoid
  • […] not limited to central nervous system affects (eg, euphoria, insomnia, seizures, cerebrovascular); alteration of prothrombin time [PT] and international normalized ratio [INR]; heart failure, arrhythmias, thromboembolism; endocrine dysfunction (eg, cushingoid[o-wm.com]
Neck Pain
  • CASE PRESENTATION: A 14-year old female caucasian patient, residing in the south of Germany, presented in the oncological outpatient clinic of our Department of Paediatrics and Adolescent Medicine in June 2014 complaining of increasing neck pain and progressive[ncbi.nlm.nih.gov]
Eruptions
  • One feature is a phenomenon known as pathergy, in which trauma to the skin can cause new eruptions of ulcers in patients with the disease. Types Two variants of the disease exist--the classic/typical and the atypical variants.[woundcarecenters.org]
  • The eruption initially appears are a pustule which enlarges and ulcerates with ill defined undermined borders that are bluish or violaceous in color. The surrounding skin also becomes edematous.[radiopaedia.org]
  • […] the skin and subcutaneous tissue, unspecified 2016 2017 2018 2019 Billable/Specific Code suppurative L08.0 Pustular rash L08.0 Pyoderma, pyodermia L08.0 Pyodermatitis L08.0 Rash (toxic) R21 ICD-10-CM Diagnosis Code R21 Rash and other nonspecific skin eruption[icd10data.com]
  • History: A 25-year-old female, with previous history of ocular dryness, was hospitalized after the rapid progression of severe skin eruption which first started at the lower limbs, then affected her face and trunk.[oatext.com]
  • Suspected induction of a pyoderma gangrenosum-like eruption due to sulpiride treatment. Cutis. 2001 ;67: 253 - 256. Google Scholar Medline ISI 39. Mir-Bonafé, JM, Blanco-Barrios, S, Romo-Melgar, A, Santos-Briz, A, Fernández-López, E.[journals.sagepub.com]
Tropical Ulcer
  • These include superficial bacterial infections such as impetigo, impetigo contagiosa, ecthyma, folliculitis, Bockhart's impetigo, furuncle, carbuncle, tropical ulcer, etc. [1] [2] Autoimmune conditions include pyoderma gangrenosum.[en.wikipedia.org]
  • Secondary pyodermas constitute tropic ulcer, infected pemphigus, infected contact dermatitis, infected scabies, and various other dermatoses infected with organisms.[ncbi.nlm.nih.gov]
Hirsutism
  • Potential side effects may be significant and include hypertension, hirsutism, tremor, hepatotoxicity, abnormalities of the central nervous system, nephrotoxicity and a potential for lymphoma development. [10], [56] Tacrolimus, a novel macrolide antibiotic[ijdvl.com]
Subcutaneous Nodule
  • Cutaneous manifestations of granulomatosis with polyangiitis (Wegener’s granulomatosis) present with purpura, ulcer, hemorrhagic bullae, livedo reticularis, and subcutaneous nodules.[wjgnet.com]

Workup

  • In both cases, a workup for systemic diseases associated with PG yielded negative results and corticosteroids were initiated by subcutaneous injection into the ulcer and/or systemic delivery.[jcm.asm.org]
  • (See Presentation, DDx, and Workup .) Patients with pyoderma gangrenosum may have involvement of other organ systems that manifests as sterile neutrophilic infiltrates.[emedicine.medscape.com]
  • Cutaneous ulcerations in patients with suspected pyoderma gangrenosum often prove, on further workup, to have a different cause.[nejm.org]
Right Pleural Effusion
  • The chest radiograph indicated patches in the right lower lung and a right pleural effusion (fig 2 A).[thorax.bmj.com]
Penicillium
  • Langerhans’-cell histiocytosis Drug induced or exogenous tissue injury Factitial disease Brown recluse spider bite Hydroxyurea Bromoderma/iododerma Contact vulvitis Infection Deep fungal infection Sporotrichosis Aspergillosis Cryptococcosis Zygomycosis Penicillium[derm101.com]
Multiple Ulcerations
  • ulcerations (at least 1 occurring on an anterior lower leg) Cribriform or “wrinkled paper” scar(s) at sites of healed ulcers Decrease in ulcer size within 1 mo of initiating immunosuppressive medication(s) First-line therapy for disseminated or localized[en.wikipedia.org]
  • Figure 1 Multiple ulcerations on legs. Peripheral blood examination showed WBC 12.9 10 9 /l with a differential count of 88% granulocytes, 12% lymphocytes; Hb 130 g/l, and platelet count 382 10 9 /l.[thorax.bmj.com]
Amyloid Plaque
  • Read More Full Text HTML Download PDF Figure 1: Alzheimer's disease (AD) is characterized by neuronal death, which is usually correlated with the appearance of amyloid plaques and neurofibrillary tangles (NFTs). (a) The Aβ pathway leading...[annualreviews.org]
Neurofibrillary Tangle
  • Read More Full Text HTML Download PDF Figure 1: Alzheimer's disease (AD) is characterized by neuronal death, which is usually correlated with the appearance of amyloid plaques and neurofibrillary tangles (NFTs). (a) The Aβ pathway leading...[annualreviews.org]

Treatment

  • Many patients respond differently to different types of treatment, for example some benefit from a moist environment, so treatment should be carefully evaluated at each stage.[en.wikipedia.org]
  • […] ulcers and number of treatment side effects.[discover.dc.nihr.ac.uk]
  • The current evidence base for clinical diagnosis and treatment of these common childhood skin disorders is highlighted.[ncbi.nlm.nih.gov]
  • Treatment Treatment of pyoderma gangrenosum is aimed at reducing inflammation, controlling pain, promoting wound healing and controlling any underlying disease.[mayoclinic.org]
  • Treatment of lesions usually involves systemic treatment, together with local therapies [5] [11]. Systemic treatments include steroids such as prednisone 40-120mg/day until healing [8] [9] [10].[worldwidewounds.com]

Prognosis

  • Prognosis Despite recent advances in therapy, the prognosis of PG remains unpredictable. The documents contained in this web site are presented for information purposes only.[orpha.net]
  • , Prevention, and Complications Prognosis chronic, relapsing ulcers leave atrophic scars when healed Please rate topic.[medbullets.com]
  • Any underlying disease significantly affects the prognosis. [ 1 ] Male sex, older age, bullous variety and association with haematological malignancy are associated with poorer prognosis.[patient.info]
  • Treatment and prognosis High dose systemic steroids are often used in severe or progressively expanding disease.[radiopaedia.org]

Etiology

  • These similarities highlight the need for a tissue diagnosis to identify infectious etiologies and rule out malignancy when BLP is suspected. J Drugs Dermatol. 2018;17(2):233-235.[ncbi.nlm.nih.gov]
  • Etiology The etiology has not yet been clearly determined.[orpha.net]
  • Mariana Rechia Bittencourt and Diogo Chagas Dalcin}, year {2013} } Clóvis Luíz Konopka, Geórgia Andrade Padulla, 3 authors Diogo Chagas Dalcin Published 2013 Pyoderma gangrenosum (PG) is a chronic dermatosis with peculiar characteristics and uncertain etiology[semanticscholar.org]
  • Pyoderma gangrenosum is a chronic, neutrophilic, progressive skin necrosis of unknown etiology often associated with systemic illness and sometimes skin injury.[msdmanuals.com]

Epidemiology

  • Given its low incidence, few studies have addressed its epidemiology or treatment.[actasdermo.org]
  • In 2011, an epidemiologic questionnaire was mailed to all members of the Finnish Fur Breeders' Association to assess the occurrence of FENP from 2009 through the first 6 months of 2011.[ncbi.nlm.nih.gov]
  • Summary Epidemiology The exact prevalence of PG is unknown. The incidence has been estimated to range between 1 and 3.3 in 330,000. The incidence peak occurs between the ages of 20 to 50 years, with women being more often affected than men.[orpha.net]
  • Introduction Necrotizing noninfectious, inflammatory disease with painful necrotic ulcers Pathogenesis due to immune dysregulation inciting event may be due to trauma Epidemiology rare common in patients 20 - 60 year of age rare in children Associated[medbullets.com]
Sex distribution
Age distribution

Pathophysiology

  • Its pathophysiological mechanisms remain controversial and many other comorbidities have been reported in the literature, including endocrinological, cardiovascular and metabolic, neoplastic and autoimmune comorbidities.[clinicaltrials.gov]
  • RESULTS Pathophysiology The pathophysiology of PG is yet to be fully elucidated, but it is most likely a complex reaction pattern with convergent pathways.[nursingcenter.com]
  • Herein, we attempt to gain insight into the pathophysiology of PG by characterizing the cellular and molecular events prior to ulcer formation and after ulcer healing.[frontiersin.org]
  • Effective strategies to prevent and treat AD remain elusive despite major efforts to understand its basic biology and clinical pathophysiology. Significant investments in therapeutic ...[annualreviews.org]
  • The pathophysiology of PG is still unclear.[journals.lww.com]

Prevention

  • Significant care should be taken with dressing changes to prevent potentially rapid wound growth.[en.wikipedia.org]
  • CONCLUSION: Recognition of this rare pathologic association is essential, to prevent delays in diagnosis and treatment that can lead to major craniofacial tissue loss. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.[ncbi.nlm.nih.gov]
  • Take precaution to prevent injuries when possible. Wear proper safety gear and avoid high impact or full contact activities. See your doctor as soon as you notice a possible ulcer. Prevention There is no known way to prevent pyoderma gangrenosum.[uvahealth.com]
  • Prevention Since the cause of pyoderma gangrenosum is unknown, there is currently no way to prevent this disease. However, the appearance of new ulcers can be prevented in patients known to have the disorder by avoiding excessive trauma to the skin.[woundcarecenters.org]
  • AIDS DAMAGED SKIN AND PREVENTS SCARRING Any time the skin is damaged, there is a potential for scarring or permanent blemish. EMUAID stimulates blood flow to rapidly promote the growth of new healthy skin cells and prevent scar tissue from forming.[emuaid.com]

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