Keywords

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

figure 1

Pyoderma gangrenosum

Photograph courtesy of SpringerImages Database, Springer Publishing Company

  • Pyoderma gangrenosum (also see Chap. 7, section 48 a(iv))

    1. A.

      The initial lesion is a tender pustule on a red or violaceous base or a red papule or nodule which is often thought to be an insect bite

figure 2

Pyoderma gangrenosum

Photograph courtesy of SpringerImages Database, Springer Publishing Company

  • Pyoderma gangrenosum

    1. A.

      The initial lesion develops into a painful ulcer with a necrotic undermined and overhanging border, which has a violet-gray gun metal color and inflammatory rim

    2. B.

      Base of ulcer may be purulent or vegetative

    3. C.

      Ulcer extends centrifugally, may rapidly expand

    4. D.

      Satellite violaceous papules which ulcerate may appear distal to the edge of the ulcer

    5. E.

      Most commonly occurs on the lower extremities (pretibial area) but may be anywhere

    6. F.

      Pathergy is common (trauma initiates and aggravates lesions)

    7. G.

      One or multiple lesions may develop

    8. H.

      Associated illnesses—seen in 50 % of patients

      1. 1.

        Inflammatory bowel disease—20–30 %

      2. 2.

        Arthritis—20 %

      3. 3.

        Hematologic malignancy—15–25 %

        1. a.

          Leukemia

        2. b.

          Myelodysplastic syndrome

        3. c.

          Monoclonal gammopathies

      4. 4.

        Drug induced

figure 3

Pyoderma gangrenosum

Photograph courtesy of SpringerImages Database, Springer Publishing Company

  • Pyoderma gangrenosum

    1. A.

      Ulcer on the lower leg with a purulent base and necrotic undermined and overhanging border which has a violet-gray gun metal color and inflammatory rim

figure 4

Pyoderma gangrenosum

Photograph courtesy of the American Academy of Dermatology

  • Pyoderma gangenosum

    1. A.

      Ulcer with irregular, necrotic undermined and overhanging borders

    2. B.

      The edge of ulcer is undermined and often has a violet-gray gun metal color and inflammatory rim with a purulent or vegetative base

a. Atypical Pyoderma Gangrenosum

figure 5

Atypical pyoderma gangrenosum

Photograph courtesy of SpringerImages Database, Springer Publishing Company

  • Atypical pyoderma gangrenosum

    1. A.

      Hemorrhagic bullae and superficial erosions

    2. B.

      Favors upper extremities (especially the dorsal hands) and face

    3. C.

      Usually occurs in the setting of leukemia and myelodysplasia

    4. D.

      Systemic features usually absent

b. Superficial Granulomatous (Vegetative) Pyoderma Gangrenosum

figure 6

Superficial granulomatous (vegetative) pyoderma grangrenosum

Photograph courtesy of SpringerImages Database, Springer Publishing Company

  • Superficial granulomatous (vegetative) pyoderma grangrenosum

    1. A.

      Localized superficial vegetative, boggy plaque

    2. B.

      Favors the trunk

c. Pyostomatitis Vegetans

figure 7

Pyostomatis vegetans

Photograph courtesy of SpringerImages Database, Springer Publishing Company

  • Pyostomatis vegetans

    1. A.

      Chronic, vegetative sterile pyoderma on the labial or buccal mucosa

    2. B.

      Multiple yellow pustules that often are arranged in linear, serpentine fashion that has been likened to a “snail track”

    3. C.

      May be associated with vegetative or ulcerative pyoderma gangrenosum

    4. D.

      Seen in patients with inflammatory bowel disease