Pyoderma gangrenosum is an inflammatory condition that begins as pustules which break down to form painful, ulcerated lesions with indurated purple borders. These ulcers often get secondary infection. They most frequently appear on the lower legs (but can appear anywhere, even around stomas). Excision or debridement of the ulcer without managing the underlying inflammatory disease results in recurrence.
- Patient History
- Haematologic malignancies
- Inflammatory bowel disease (2%)
- Rheumatoid arthritis
- Signs and symptoms
- Pustules → painful, ulcers with indurated purple borders
- Extracutaneous presentation
- Pulmonary infiltrates
- Investigation
- Biopsy: to differentiate from other inflammatory, infectious and malignant lesions
- Treatment
- Treat the associated inflammatory disease e.g. Infliximab for Crohn’s disease
- Systemic steroids
- Topical or systemic antimicrobials
- Local wound care
