Practical aspects of the diagnosis and management of pyoderma gangrenosum

Pyoderma gangrenosum (PG) is a rare autoinflammatory ulcerative neutrophilic skin disease. Its clinical presentation is a rapidly progressing painful skin ulcer with ill-defined borders and surrounding erythema. The pathogenesis of PG is complex and not fully understood. Clinically, patients with PG often have various systemic diseases, the most common being inflammatory bowel disease (IBD) and arthritis. Due to the lack of specific biological markers, diagnosing PG remains difficult, which easily resulting in misdiagnosis. Some validated diagnostic criteria have been applied in clinical practice that facilitate its diagnosis. The treatment of PG currently consists mainly of immunosuppressive and immunomodulatory agents, especially biological agents, which have bright prospects for PG therapy. After the systemic inflammatory response is controlled, the problem of wounds becomes the main contradiction in PG treatment. Surgery is not controversial for PG, increasing evidence shows that with adequate systemic treatment, the benefits of reconstructive surgery for patients are increasing.

Automated summary

Pyoderma gangrenosum (PG) is a rare autoinflammatory ulcerative neutrophilic skin disease characterized by rapidly progressing painful ulcers with ill-defined borders and surrounding erythema. The pathogenesis of PG is complex and not completely understood. Patients with PG often have various systemic diseases, with inflammatory bowel disease (IBD) and arthritis being the most common. Accurate diagnosis of PG is challenging due to the lack of specific biological markers, but validated diagnostic criteria have been useful in clinical practice. Treatment for PG mainly involves immunosuppressive and immunomodulatory agents, particularly biological agents, which show promising prospects. Once the systemic inflammatory response is controlled, wound management becomes the main concern in PG treatment, and reconstructive surgery has demonstrated increasing benefits when combined with adequate systemic treatment.