Pyoderma Gangrenosum

Etiology

  • Inflammatory process causing skin necrosis and ulceration

Risk Factors

  • Ulcers that develop in association w/IBD, cancer (e.g. pancreatic, leukemia), other systemic autoimmune disorders (e.g. RA)

Symptoms

  • Often begins as pustules, which rapidly progress, coalesce and cause skin breakdown
  • Most common in legs, though also in unusual places (e.g. chest wall)
  • Develop w/o clear explanation or following minor trauma (pathergy)
  • Typically painful and progressive
  • Non-responsive to usual wound care; not responsive to antibiotics (unless secondarily infected)

Physical Exam Findings

  • Ulcers can appear necrotic, beefy red, or with eschar
  • Sometimes surrounding erythema
  • Borders are usually well defined
  • Can become secondarily infected

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