[Pyoderma gangrenosum: pathogenesis, diagnosis, and treatment]

Area of Science:

• Dermatology
• Immunology
• Wound Healing

Background:

• Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by painful, ulcerative skin lesions.
• Its exact pathophysiology remains unclear but is linked to autoinflammation and neutrophil activity.
• PG often co-occurs with inflammatory conditions like inflammatory bowel disease and cancer.

Purpose of the Study:

• To provide a comprehensive overview of Pyoderma gangrenosum.
• To discuss diagnostic criteria and current therapeutic strategies.
• To highlight recent advancements in PG management.

Main Methods:

• Literature review of Pyoderma gangrenosum pathophysiology, diagnosis, and treatment.
• Analysis of diagnostic tools, including the PARACELSUS score.
• Summary of current and emerging systemic and topical therapies.

Main Results:

• PG presents as rapidly progressing papules or pustules leading to painful ulcers with characteristic edges.
• Diagnosis is supported by the PARACELSUS score, integrating nonspecific criteria.
• Treatment involves immunosuppressants (e.g., prednisolone, ciclosporin), biologics, small molecules, and IV immunoglobulins.

Conclusions:

• Pyoderma gangrenosum requires a multidisciplinary approach combining systemic pharmacotherapy and advanced wound care.
• Increased utilization of biologics and small molecules marks a shift in PG treatment.
• Effective management necessitates addressing comorbidities and implementing modern wound and pain therapy.