PASH syndrome is an exceedingly rare disorder characterized by the triad of pyoderma gangrenosum (PG), acne, and hidradenitis suppurativa (HS).
The clinical course of PASH syndrome varies, but most individuals typically present with recurrent and episodic severe, nodulocystic, scarring acne and HS lesions during adolescence. PG lesions typically occur later in adulthood.
The genetics and pathophysiology of PASH syndrome remain largely unknown. However, proinflammatory cytokines interleukin (IL)-1 and tumor necrosis factor (TNF) are elevated in skin biopsies. Unlike PAPA syndrome, these cytokines are typically absent from peripheral blood, suggesting that systemic inflammation in PASH syndrome may be less pronounced. Additionally, mutations in several genes, including PSTPIP1 and NCSTN, have been identified in a small number of individuals with PASH syndrome.
PASH syndrome
Alerts and Notices
Important News & Links
Synopsis

Codes
ICD10CM:
L98.9 – Disorder of the skin and subcutaneous tissue, unspecified
SNOMEDCT:
74578003 – Pyoderma gangrenosum
L98.9 – Disorder of the skin and subcutaneous tissue, unspecified
SNOMEDCT:
74578003 – Pyoderma gangrenosum
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- PAMI syndrome (PSTPIP1-associated myeloid-related proteinemia inflammatory)
- PAPASH syndrome (pyogenic arthritis, pyoderma gangrenosum, acne, and hidradenitis suppurativa)
- PAPA syndrome (pyogenic arthritis, pyodermic gangrenosum, and acne)
- PAC syndrome (pyoderma gangrenosum, acne, and ulcerative colitis)
- SAPHO syndrome (synovitis-acne-pustulosis-hyperostosis-osteitis)
- Familial Mediterranean fever
- Blau syndrome
- Early-onset granulomatosis
- CANDLE syndrome (chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature)
- Deficiency of IL-1 receptor antagonist (DIRA) syndrome
- Deficiency of IL-36 receptor antagonist (DITRA) syndrome
- Cryopyrin-associated periodic syndromes (CAPS)
- TNF receptor-associated periodic syndrome (TRAPS)
- Hyperimmunoglobulinemia D (hyper-IgD) syndrome
- Macrophage activation syndrome
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
References
Subscription Required
Last Reviewed:04/22/2019
Last Updated:04/19/2022
Last Updated:04/19/2022