Difference between revisions of "Pyoderma gangrenosum"
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'''Pyoderma gangrenosum''' is a benign [[inflammatory skin disorder]] associated with [[inflammatory | '''Pyoderma gangrenosum''', abbreviated '''PG''', is a benign [[inflammatory skin disorder]] associated with [[inflammatory bowel disease]]. | ||
==General== | ==General== | ||
*May be seen in [[IBD]] ( | *May be seen in [[IBD]] ([[ulcerative colitis]] and [[Crohn's disease]]) - approximately 30% of cases.<ref name=pmid16858047/> | ||
Clinical | Clinical | ||
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The vasculitis is seen superficially and is likely secondary to the ulceration. | The vasculitis is seen superficially and is likely secondary to the ulceration. | ||
</pre> | |||
===Alternate=== | |||
<pre> | |||
Skin, Left Lower Leg, Punch Biopsy: | |||
- Skin with ulceration, necrotic debris, superficial vasculitis, | |||
subepidermal fibrosis and maturing granulation tissue, see comment. | |||
- NEGATIVE for evidence of malignancy. | |||
Comment: | |||
The findings are in keeping with pyoderma gangrenosum; however, vasculitis and | |||
atherosclerosis should be considered clinically. | |||
The vasculitis is seen superficially and is favoured to be secondary to | |||
the ulceration. | |||
</pre> | </pre> | ||
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[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category: | [[Category:Dermatopathology]] | ||
Latest revision as of 14:53, 5 November 2015
Pyoderma gangrenosum, abbreviated PG, is a benign inflammatory skin disorder associated with inflammatory bowel disease.
General
- May be seen in IBD (ulcerative colitis and Crohn's disease) - approximately 30% of cases.[1]
Clinical
Gross
- Skin ulceration - classically on the legs.[1]
Microscopic
Features:[1]
- Early: lymphocytes cells only in the dermis - often perivascular & vascular.
- +/-Fibrinoid necrosis of vessels at edge of lesion.
- Late: abscess formation (neutrophils).
DDx:
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A. Skin, Left Leg from Central Wound, Punch Biopsy: - Necrotic debris with underlying granulation tissue and benign connective tissue with superficial vasculitis, see comment. - NEGATIVE for skin surface. B. Skin, Left Leg from Wound and Normal Skin Junction, Punch Biopsy: - Skin with ulceration, necrotic debris, and superficial vasculitis, see comment. - Fat necrosis and severe atherosclerosis. Comment: The findings are in keeping with pyoderma gangrenosum; however, atherosclerotic disease and vasculitis should be considered clinically. The vasculitis is seen superficially and is likely secondary to the ulceration.
Alternate
Skin, Left Lower Leg, Punch Biopsy: - Skin with ulceration, necrotic debris, superficial vasculitis, subepidermal fibrosis and maturing granulation tissue, see comment. - NEGATIVE for evidence of malignancy. Comment: The findings are in keeping with pyoderma gangrenosum; however, vasculitis and atherosclerosis should be considered clinically. The vasculitis is seen superficially and is favoured to be secondary to the ulceration.
See also
References
- ↑ 1.0 1.1 1.2 Brooklyn, T.; Dunnill, G.; Probert, C. (Jul 2006). "Diagnosis and treatment of pyoderma gangrenosum.". BMJ 333 (7560): 181-4. doi:10.1136/bmj.333.7560.181. PMC 1513476. PMID 16858047. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513476/.
- ↑ Wong, WW.; Machado, GR.; Hill, ME.. "Pyoderma gangrenosum: the great pretender and a challenging diagnosis.". J Cutan Med Surg 15 (6): 322-8. PMID 22202507.