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Pyoderma gangrenosum underrepresentation in non-dermatological literature
Ashley M Reese1, Carter K Haag1, Enjae Jung2
1Department of Dermatology, School of Medicine, Oregon Health and Science University, Portland, OR, USA.
Diagnosis (Berlin, Germany)
|January 9, 2020
Summary
Pyoderma gangrenosum (PG) is often misdiagnosed due to its absence in surgical and emergency medicine literature. Including PG in differential diagnoses for chronic ulcers and necrotizing soft tissue infections (NSTI) is crucial for accurate diagnosis and management.
Area of Science:
- Dermatology
- Medical Education
- Surgical Specialties
Background:
- Pyoderma gangrenosum (PG) is a challenging neutrophilic dermatosis with no definitive diagnostic markers.
- PG is frequently misdiagnosed, often confused with necrotizing soft tissue infections (NSTI).
Purpose of the Study:
- To assess the representation of Pyoderma gangrenosum (PG) in surgical and emergency medicine literature.
- To identify knowledge gaps in diagnosing PG among non-dermatology specialists.
Main Methods:
- A review of major surgical, emergency medicine, and dermatology textbooks.
- A literature search for review articles on necrotizing soft tissue infections (NSTI) and necrotizing fasciitis (NF).
Main Results:
- Pyoderma gangrenosum (PG) was underrepresented in non-dermatology textbooks and NSTI review articles.
- Only a few non-dermatology textbooks included PG in their differential diagnoses.
- Dermatology textbooks consistently included PG, but often not in the context of NSTI.
Conclusions:
- Underrepresentation of PG in non-dermatology literature contributes to misdiagnosis and mismanagement.
- Recommendations include adding PG to differential diagnoses for chronic ulcers and NSTI in non-dermatology texts.
- Educational modules for surgical and emergency specialties should cover inflammatory mimics like PG.
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