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Pyoderma Gangrenosum: A Critical Appraisal
Eran Shavit1, Afsaneh Alavi, R Gary Sibbald
1Eran Shavit, MD • Dermatologist, Clinical Fellow • Division of Dermatology, Department of Medicine • Women's College Hospital, University of Toronto • Toronto, Ontario, Canada Afsaneh Alavi, MD, MSc, FRCPC • Assistant Professor • Division of Dermatology, Department of Medicine • Women's College Hospital, University of Toronto • Toronto, Ontario, Canada R. Gary Sibbald, MD, DSc (Hons), MEd, BSc, FRCPC (Med)(Derm), FAAD, MAPWCA • Professor • Medicine and Public Health • University of Toronto • Toronto, Ontario, Canada • Director • International Interprofessional Wound Care Course & Masters of Science in Community Health (Prevention & Wound Care) • Dalla Lana Faculty of Public Health • University of Toronto • Past President • World Union of Wound Healing Societies • Clinical Editor • Advances in Skin & Wound Care • Philadelphia, Pennsylvania.
General Purpose:
To provide information about pyoderma gangrenosum (PG), including pathophysiology, diagnostic criteria, and treatment.
Target Audience:
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.
Learning Objectives/Outcomes:
After participating in this educational activity, the participant should be better able to: ABSTRACT: Pyoderma gangrenosum (PG) is an uncommon cutaneous disease, presenting with recurrent painful ulcerations most commonly on the lower extremities. The diagnosis is made according to a typical presentation, skin lesion morphology, skin biopsy, histopathology, and the exclusion of other etiologies. Classically, PG presents with painful ulcers with well-defined violaceous borders; other variants including bullous, pustular, and vegetative/granulomatous can also occur. Treatment of PG involves a combination of topical and systemic anti-inflammatory and immunosuppressive medications, wound care, antimicrobial agents for secondary infections, and treatment of the underlying etiology. This article is a continuing education review of the literature with a focus on the clinical application of the pathophysiology, diagnosis, and treatment of this challenging disease.
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