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]
Discussion This case showed an atypical and unusual presentation of PG. [karger.com]
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]
Entire Body System
- Localized Edema
A few hours after the second intervention, the patient developed fever (body temperature 38ºC) and significant local edema, with extravasation of serosanguineous secretion (seroma) that infiltrated the subcutaneous cellular tissue and reached the breasts [rbcp.org.br]
Skin
- 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 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]
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]
Vesiculopustular eruption of ulcerative colitis. Arch Dermatol 1983;119: 664-9. [PubMed] [Google Scholar] 7. Callen JP, Woo TY. Vesiculopustular eruption in a patient with ulcerative colitis. Pyoderma gangrenosum. Arch Dermatol 1985;121: 399, 402. [ncbi.nlm.nih.gov]
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]
A complete clinical workup is mandatory. Table II. [dermatologyadvisor.com]
(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]
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]
Using a standardized questionnaire, a German survey on the treatment of PG among wound experts revealed that 11 % of PG patients exclusively received topical treatment; 22.7 %, only systemic treatment; and 66.2 %, combined topical and systemic therapy [onlinelibrary.wiley.com]
Despite recent advances in treatment, the prognosis of PG remains unpredictable.1 The optimal treatment of PG includes a combination of local wound care and systemic treatment. [ard.bmj.com]
Treatment Treatment of pyoderma gangrenosum is aimed at reducing inflammation, controlling pain, promoting wound healing and controlling any underlying disease. [mayoclinic.org]
Number of treatment failures - treatment failures are defined as being participants who withdraw (or are withdrawn) from their randomised treatment because of treatment intolerance or worsening of the PG, or those who continue to have any unhealed ulcers [isrctn.com]
Prognosis
Prevention, and Complications Prognosis chronic, relapsing ulcers leave atrophic scars when healed Please rate topic. [medbullets.com]
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]
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]
PubMed Pyoderma gangrenosum: treatment and prognosis. UpToDate. Available at: https://www.uptodate.com/contents/pyoderma-gangrenosum-treatment-and-prognosis. Accessed 24 February 2019. Keyal U, Liu Y, Bhatta AK. [dermnetnz.org]
Etiology
The etiology of pyoderma is unclear. Half of patients have a systemic inflammatory condition such as ulcerative colitis, Crohn’s disease, irritable- bowel syndrome, lupus, or rheumatoid arthritis. [woundeducators.com]
Favorite Table | Print Pyoderma Gangrenosum at a Glance Pyoderma gangrenosum (PG) is a rare inflammatory disease of unknown etiology characterized by sterile neutrophilic infiltration of the skin. [accessmedicine.mhmedical.com]
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]
Epidemiology
Given its low incidence, few studies have addressed its epidemiology or treatment. [actasdermo.org]
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]
Pyoderma gangrenosum: A clinico-epidemiological study. [ijdvl.com]
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]
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]
Etiology Pathophysiology The etiology of PG is unknown, and its pathogenesis is poorly understood. [dermatologyadvisor.com]
Prevention
Prevention There are no current guidelines to prevent pyoderma gangrenosum. [winchesterhospital.org]
Prevention There are no current guidelines to prevent pyoderma gangrenosum. References Charles CA, Leon A, Banta MR, Kirsner RS. Etanercept for the treatment of refractory pyoderma gangrenosum: a brief series. Int J Dermatol. 2007;46(10):1095-1099. [lahey.org]
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]
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]
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]