Gameiro A, Pereira N, Cardoso JC, Gonçalo M, et al.
Clinical, cosmetic and investigational dermatology. Date of publication 2015 May 28;volume 8():285-93.
1. Clin Cosmet Investig Dermatol. 2015 May 28;8:285-93. doi: 10.2147/CCID.S61202.
eCollection 2015.
Pyoderma gangrenosum: challenges and solutions.
Gameiro A(1), Pereira N(2), Cardoso JC(1), Gonçalo M(1).
Author information:
(1)Dermatology Department, Coimbra University Hospital, Coimbra, Portugal.
(2)Dermatology Department, Centro Hospitalar Cova da Beira, Covilhã, Portugal.
Pyoderma gangrenosum (PG) is a rare disease, but commonly related to important
morbidity. PG was first assumed to be infectious, but is now considered an
inflammatory neutrophilic disease, often associated with autoimmunity, and with
chronic inflammatory and neoplastic diseases. Currently, many aspects of the
underlying pathophysiology are not well understood, and etiology still remains
unknown. PG presents as painful, single or multiple lesions, with several
clinical variants, in different locations, with a non specific histology, which
makes the diagnosis challenging and often delayed. In the classic ulcerative
variant, characterized by ulcers with inflammatory undermined borders, a broad
differential diagnosis of malignancy, infection, and vasculitis needs to be
considered, making PG a diagnosis of exclusion. Moreover, there are no
definitively accepted diagnostic criteria. Treatment is also challenging since,
due to its rarity, clinical trials are difficult to perform, and consequently,
there is no "gold standard" therapy. Patients frequently require aggressive
immunosuppression, often in multidrug regimens that are not standardized. We
reviewed the clinical challenges of PG in order to find helpful clues to improve
diagnostic accuracy and the treatment options, namely topical care, systemic
drugs, and the new emerging therapies that may reduce morbidity.
DOI: 10.2147/CCID.S61202
PMCID: PMC4454198
PMID: 26060412
