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Pyoderma gangrenosum: a review
A Neil Crowson1, Martin C Mihm, Cynthia Magro
1Department of Dermatology, University of Oklahoma, Tulsa, OK, USA. ncrowson@sjmc.org
Abstract:
Since its first description in 1930, the pathogenesis of pyoderma gangrenosum (PG) has remained obscure even as an ever-widening array of systemic diseases has been described in association with it. The histopathologic distinction of PG from other ulcerative processes with dermal neutrophilia is challenging and at times impossible. In consequence, when confronted with a biopsy from such a lesion, the pathologist has an obligation to obtain a full and detailed clinical history. In short, as a diagnosis of PG does not hinge exclusively upon the biopsy findings in isolation from other studies, a solid knowledge of the clinical features, the systemic disease associations and the differential diagnosis will help the pathologist to avoid diagnostic pitfalls or the generation of a report which is non-contributory to patient care. In this review, we describe in detail the different clinicopathologic forms of PG, summarize the diseases associated with this process in the literature and in our experience, and briefly review the treatment options.
Insights
Pyoderma gangrenosum (PG) pathogenesis remains unclear, making diagnosis difficult. This review details PG
Area of Science:
- Dermatology
- Pathology
Background:
- Pyoderma gangrenosum (PG) pathogenesis is poorly understood since its 1930 description.
- Histopathologic differentiation of PG from other ulcerative conditions with dermal neutrophilia is challenging.
- Accurate diagnosis requires integrating clinical history with biopsy findings.
Purpose of the Study:
- To review the clinicopathologic features of pyoderma gangrenosum.
- To summarize systemic diseases associated with PG.
- To briefly discuss treatment options for PG.
Main Methods:
- Literature review of pyoderma gangrenosum.
- Analysis of clinical and pathological data.
- Summary of associated systemic diseases and treatments.
Main Results:
- Detailed description of various clinicopathologic forms of PG.
- Compilation of systemic diseases associated with PG from literature and clinical experience.
- Overview of current treatment strategies for PG.
Conclusions:
- Diagnosis of PG necessitates a comprehensive approach beyond biopsy findings.
- Understanding clinical features and associated diseases is crucial for accurate diagnosis and patient care.
- This review provides a consolidated resource for pathologists and clinicians managing PG.
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