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Pyoderma gangrenosum - Cellulitis
See also in: Overview,Anogenital
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Pyoderma gangrenosum - Cellulitis

See also in: Overview,Anogenital
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Contributors: Tara Mahar MD, Art Papier MD
Other Resources UpToDate PubMed

Synopsis

Pyoderma gangrenosum (PG) is an inflammatory, noninfectious, ulcerative skin disease of uncertain etiology commonly misdiagnosed as an aggressive skin infection. Pustules form and give way to ulcers with a necrotic, undermined margin. PG can affect any age and take on a number of differing clinical presentations. The 2 primary variants are a classic ulcerative form, which often involves the lower extremities, and atypical PG, which is more superficial and tends to occur on the hands. Fever, toxicity, and pain can be associated with the onset of the skin lesions of PG. Extracutaneous manifestations may take the form of sterile neutrophilic abscesses, such as in the lungs, heart, GI tract, liver, eyes, CNS, and lymphatic tissue.

Though the exact cause is unknown, PG has associations with a number of systemic illnesses. In about 50% of cases, there is an association between PG and systemic diseases such as ulcerative colitis, Crohn's disease, arthritis, myeloma, leukemia, monoclonal gammopathy, granulomatosis with polyangiitis, collagen vascular disease, Behçet's disease, and many other disorders. There is no racial or sex predilection. The disease occurs most often in middle-aged adults. PG tends to be self-limited, and although first-line therapies are widely accepted, alternative therapeutic recommendations are largely based on anecdotal evidence. Surgical intervention is a common exacerbating factor because skin trauma can lead to worsening disease. PG can have either an acute or chronic course and result in extensive scarring.

Codes

ICD10CM:
L88 – Pyoderma gangrenosum

SNOMEDCT:
74578003 – Pyoderma gangrenosum

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Ulcers:
Pustules/Nodules:
The differential diagnosis for an immunocompromised patient also includes:

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 10/26/2017
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Pyoderma gangrenosum - Cellulitis
See also in: Overview,Anogenital
Print 4 Images
View all Images (4)
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Pyoderma gangrenosum : Painful skin lesions, Skin ulcer
Clinical image of Pyoderma gangrenosum
Copyright © 2019 VisualDx®. All rights reserved.