What is Pyoderma Gangrenosum?
Pyoderma gangrenosum is an uncommon condition that causes tissues to become necrotic. This condition causes deep ulcers that happen most commonly on the legs. They can lead to chronic wounds that are very painful and could lead to scarring. They start off looking like a small bug bite then will transform into larger ulcers. They are often quick spreading reddish to purplish bumps or blisters. Once they have developed into ulcers, they will have a clearly defined blue or violet colored border on them. There is no definite size or depth to them. It was first discovered in 1930, and effects about 1 in 100,000 individuals. It can effect any age group, but happens most commonly in individuals in their 40s and 50s. Fever, joint tenderness, localised tenderness and a general feeling of not feeling well are all associated with pyoderma gangrenosum. Half of all cases are associated with other disorders, including inflammatory bowel disease, myeloid metaplasia, rheumatic arthritis, acute and chronic myelogenous leukemia, Crohn’s disease, and paraproteinemias. More females then males have pyoderma gangrenosum.
There are many types of Pyoderma Gangrenosum. These include:
- Typical pyoderma gangrenosum– May also be referred to as classic PG, or Peristomal pyoderma gangrenosum. This commonly effects the legs or the trunk. Often occurs near surgical openings in the body. This unusual variation of the condition is seen exclusively with individuals that suffer from inflammatory bowel disease (IBD). Approximately 15% of all cases are peristomal.
- Atypical pyoderma gangrenosum– This variation of the condition effects the hands and other portions of the body. It is more superficial than typical Pyoderma Gangrenosum. Commonly associated with IBD, but can occur with other systemic illnesses. Can also be referred to as Bulous Pyoderma Gangrenosum.
- Pustular Pyoderma Gangrenosum– An uncommon clinical form of Pyoderma Gangrenosum. Painful bumps are often found on the arms and legs. This is often associated with IBD as well.
- Vegetative pyoderma gangrenosum– This condition is characterised by ulcers that are usually not painful. It can respond well to topical treatments. Lesions are usually found on the neck and head. Usually found as a single lesion on a healthy person.
What Causes Pyoderma Gangrenosum?
While there is no known cause to Pyoderma Gangrenosum, the condition is suspected to be an autoimmune disorder. Should you have Pyoderma Gangrenosum, a new injury to the skin could result in new ulcers forming.
Pyoderma Gangrenosum Treatment
A variety of tests might be needed when diagnosing for Pyoderma Gangrenosum. Blood may be taken to check for any infection, kidney, liver, or thyroid functions, and rheumatoid factors, which determine rheumatoid arthritis. A sample of the skin may be taken or a small amount of liquid from the ulcers to do a biopsy.
Medication can be prescribed to help treat Pyoderma gangrenosum. High doses of corticosteroids are often used as an effective treatment, however there are unwanted side effects, such as thinning bones, weight gain, and an increased infection rate. Sulfa drugs, such as dapsone or sulfapyridine, can be prescribed as well. Do note that with any treatment offered, it could take weeks or even months for the skin to heal.
Surgery is often another treatment used for this skin condition. Surgery is often not used as there could be more trauma to the skin, or make the existing ulcers worse. Skin grafting is sometimes needed after the inflammation has gone down and the wound begins to heal.
Pyoderma Gangrenosum Prevention
It is extremely hard to prevent Pyoderma Gangrenosum. Controlling the disorders that are associated with pyoderma gangrenosum is the best place to start. Avoid injury to the skin to avoid new ulcers from forming.