What is Pyoderma Gangrenosum?
The skin tissues become necrotized in a condition called Pyoderma gangrenosum (PG). The condition is named such because of the purulent discharge (pyoderma) and blue-black edge (gangrenosum). This usually leads to the development of deep skin ulcerations. Though this may affect nearly every part of the body, the legs are more commonly affected. Pyoderma gangrenosum is also among the main culprit of chronic wounds. The appearance of pyoderma gangrenosum may be extremely repulsive. Initially, this may look like tiny bug bites. Nevertheless, as the condition progresses, the small wounds would evolve to really huge craters.
This condition was first identified during the 1930s and its exact cause is still being closely studied until this very day. Studies have found that immune system problems may be related to pyoderma gangrenosum. It has also been additionally reported that the majority of those who have pyoderma gangrenosum also have chronic medical conditions like diabetes mellitus. Pyoderma gangrenosum may seem to be a serious condition but this rarely leads to death.
There are generally two types of pyoderma gangrenosum. The first one is the typical which primarily develops on the legs. On the other hand, the atypical pyoderma gangrenosum appears on the hands as well as on other parts of the body.
Though nearly all of us may be affected by pyoderma gangrenosum, older people especially those aged 40 and older are slightly at risk to it. This is also considered to be a rare condition. One in every 100,000 people may be affected. You’ll find out more about this condition as you read on this post.
Symptoms of Pyoderma Gangrenosum
Different types of pyoderma gangrenosum may have various presentations. This makes it difficult to determine the presence of the condition in an instant. You may suspect that someone could be suffering from PG when any of the symptoms listed below are present.
- Appearance of small bumps on the skin that may look like spider bites
- Skin ulcerations with purplish border (usually seen on the lower leg)
- Painful joints
- Generalized body weakness
- Presence of non-healing wounds and the wounds immediately progress in size within just a matter of 48 hours
- Pathergy- The presence of ulcers on the trauma site
When several of the above symptoms are present you could suspect of PG and you should immediately refer to your doctor for further diagnosis and prompt treatment.
Scientists are still looking for the exact cause of pyoderma dermatitis yet they remained baffled. Through in-depth studies, the existence of immune system defects has been linked to the development of pyoderma gangrenosum. Nevertheless, the majority of pyoderma gangrenosum cases remain to be idiopathic or have unknown cause. Below is a list of the conditions that may possibly be associated with PG:
- Antiphospholipid syndrome
- Arthritis (specifically rheumatoid arthritis and seronegative arthritis)
- Inflammatory bowel diseases (IBD) like Crohn’s disease and ulcerative colitis
- Liver diseases (e.g. chronic active hepatitis)
- Myeloproliferative diseases (including lymphoma, myeloma and leukemia)
- Paroxysmal nocturnal hemoglobinuria
- Systemic lupus erythematosus
- Wegener’s granulomatosis
These are just among the possible triggers for PG. Trauma to the skinn such as punctures and cuts may also lead to the development of ulcers. Undergoing a certain surgical procedure may predispose one to PG. Even a small insect bite would also trigger PG.
It is often tricky to diagnose PG due to its varied presentations. That’s why soon as you notice any unexplained itch and blistering alongside the presence of poorly healing wounds, you should right away consult your doctor to assess your condition. Among the commonly performed tests to determine the presence of PG are:
This would help rule out the presence of other diseases. The patient may also be checked for the presence of autoantibodies through a blood test. Autoantibodies are generally present in inflammatory bowel diseases.
Culture – A swab of the ulceration may also be obtained and sent to the lab for further analysis.
Biopsy – Doctors primarily indicate this to rule out other conditions. Even with biopsy, diagnosis of PG still remains tricky.
Seeking medical consultation would guarantee you prompt treatment. The main aim of PG treatment is to control the worsening of the skin ulcerations. Healing the wounds is also another goal. Here are among the commonly prescribed medicines to treat PG:
Corticosteroids are generally given to patients with pyoderma gangrenosum to halt the ongoing inflammatory process. Oral corticosteroids are preferred over the other forms. Minor cases of PG may however just be treated with topical corticosteroids. There are some considerations though when taking this medication as this may lead to increased blood pressure.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) – These may also be given to manage the pain suffered by patients with PG.
Immunosuppressant drugs are also helpful in controlling the activities of the immune system which can be considered both a bad and good thing because suppressing the immune system would put you at risk for infections.
Intravenous Immunoglobulin – High doses of IV Ig are also given when patients are resistant to corticosteroids.
Tumor Necrosis Factor Inhibitor – These drugs are found to be effective in treating PG. On the other hand, this also makes the patient vulnerable to both different types of infection and cancer.
Surgery – Surgery is primarily performed to eliminate necrotic tissues and promote healing. Nevertheless, surgery is rarely done as this may only aggravate PG.
Soon as your condition improves, the doses of any of the above mentioned medications are usually tapered, specifically corticosteroids. Soon as the treatment is started, within several months improvements on the skin condition can be readily seen.
If you had previously suffered from pyoderma gangrenosum, you should take the necessary precautionary measures the next time and these include wearing protective garments to prevent any skin injury. You may also apply antibacterial creams and other ointments to reduce the possibility of scarring. Remember that prompt treatment is the key to managing the condition. When the condition is just left untreated, the ulcerations would just increase in size. Prompt treatment, on the other hand, would promote speedy healing. Your browser may not support display of this image.
Pyoderma Gangrenosum Pictures
Pictures, Photos and Images of the medical condition Pyoderma Gangrenosum…