Pyoderma gangrenosum is a chronic, neutrophil, progressive skin necrosis of unknown etiology that often occurs in the context of a systemic disease.

Pyoderma gangrenosum is a chronic, neutrophil, progressive skin necrosis of unknown etiology that often occurs in the context of a systemic disease. Etiology The etiology is unknown, but the pyoderma gangrenosum often associated with various systemic diseases, including vasculitis, gammopathy, rheumatoid arthritis, leukemia, lymphoma, Hepatitis C virus infections, SLE, sarcoidosis, rheumatoid arthritis, Behcet’s disease, hidradenitis suppurativa and v. a. with inflammatory bowel disease. It is believed that it is caused by an abnormal immune response. Most patients are at an age of 25 to 50 years. It can manifest itself in different subtypes. Pathophysiology About the pathophysiology is poorly understood, but it could include problems with the neutrophil chemotaxis. There is an IL-8 overexpression in front in the lesions. Ulceration of pyoderma gangrenosum occur after injury to the skin in about 30% of patients. This process is called pathergy. Symptoms and complaints Pyoderma gangrenosum usually starts with an inflamed erythematous papule, pustule or nodule. The lesion, which often reminded at this stage to a boil or a Arthropodenbiss eventually ulcerated and expands rapidly out to form a swollen necrotic base with raised gloomy red to livid margin. A undermined border (d. E. Loss underlying supporting tissue at the boundary) is common, but not pathognomonic. Systemic symptoms such as fever and malaise are common. The ulcers can merge to form larger lesions, often with siebförmiger scarring. The symptoms and characteristics vary depending on the subtype very: ulcerative (classic) subtype: This is the most common subtype in the form described above ulcers, usually in the lower extremities or on the trunk, especially on the buttocks and perineum. Bullous (atypical) subtype: This less common subtype often develops in patients with hematological diseases. The lesions usually begin as bubbles that erode and become superficial ulcers. The arms and the face is most commonly affected. Pustular Subtype: This subtype is developing normally during exacerbations of inflammatory bowel disease. It develop painful pustules that are surrounded by redness. Joint pain are common. Vegetative (superficial pyoderma gangrenosum) Subtype: This subtype is a single, indolent, slightly painful plaque or a superficial ulcer develops, usually on the head or neck. The border is not undermined and the base does not necrotic. Pyoderma gangrenosum (Classic subtype) © Springer Science + Business Media var model = {thumbnailUrl: ‘/-/media/manual/professional/images/514-pyoderma-gangrenosum-classic-subtype-slide-13-springer-high_de.jpg? lang = en & thn = 0 & mw = 350 ‘, imageUrl:’ /-/media/manual/professional/images/514-pyoderma-gangrenosum-classic-subtype-slide-13-springer-high_de.jpg?la=de&thn=0 ‘ title: ‘pyoderma gangrenosum (classic sub-type),’ description ‘ u003Ca id = “v37894818 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDiese figure shows an ulcerated lesion with a necrotic base and increased dark to violet border on the leg u003c / p u003e u003c / div u003e ‘credits’. © Springer Science + Business Media’

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