By Disease Name > Pyoderma Gangrenosum

Pyoderma Gangrenosum

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4 types:

 

1.ULCERATIVE (classic PG)
2.hmtoggle_plus1        PUSTULAR (form fruste of classic)
•the primary pustular lesion that may or may not progress to ulcerative lesion
•often in patients with IBD
3.hmtoggle_plus1        BULLOUS (overlap with atypical Sweet's)
•more superficial and less destructive
•often in patients with hematologic malignancy
4.hmtoggle_plus1        VEGETATIVE (AKA superficial granulomatous PG)
•least aggressive form
•cribriform chronic superficial ulcerations usually of the trunk

 

 

 

•overall, ~50% of patients have an associated disease
•most common = IBD (the two disease may run an independent course)
•~10% have a monoclonal gammopathy (usually IgA)

 

hmtoggle_plus1differential diagnosis:
•infectious (deep fungal, mycobacteria, gummatous syphilis)
•halogenoderma
•spider bite
•factitial (most difficult diagnosis to exclude)

 

treatment:

•Lebwohl's treatment algorithm:  first line: intralesional steroid injection and protopic 0.1% topically, then TNF-alpha blocker
•PO:  prednisone (1mg/kg or more)

 

 

see NEUTROPHILS