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by McCoy K

Definition

A skin ulcer is an open sore in the skin. Pyoderma gangrenosum is an uncommon form of skin ulcers. It usually occurs on the lower legs, but can occur anywhere on the skin.

Side View of Skin Ulcer
Skin Ulcer small
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Causes

Pyoderma gangrenosum is thought to be caused by a problem with the immune system. The immune system finds and attacks foreign items in the body like viruses. Sometimes the immune system attacks the body's own tissue. In this case, the immune system attacks an area of the skin.

Risk Factors

Pyoderma gangrenosum is more likely to occur in people who have other underlying medical conditions such as:

Symptoms

The main symptom of pyoderma gangrenosum is a painful skin ulcer. These ulcers may begin as small-irritated bumps from an injury. However, the ulcer can grow up to 7.9 in (inches) (20 cm [centimeters]). The ulcers often have purple edges that appear worn away.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a skin specialist. Pyoderma gangrenosum is diagnosed by its appearance. Your doctor will also want to rule out other conditions that can cause skin ulcers.

To look for other factors that could cause ulcers, your doctor may order:

  • Sample of ulcer fluids—to look for infection or items that can cause infection
  • Biopsy —a tissue sample examined under a microscope
  • Blood tests

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Medications

Medications to treat pyoderma gangrenosum include:

  • Oral corticosteroids
  • Immunosuppressants
  • Smaller ulcers may be treated with a topical steroid cream or an injection

You may need other medications to treat any underlying conditions

Preventing New Ulcers

Ulcers often begin at the site of injuries. Take precaution to prevent injuries when possible. Wear proper safety gear and avoid high impact or full contact activities.

See your doctor as soon as you notice a possible ulcer.

Prevention

There are no current guidelines to prevent pyoderma gangrenosum.

RESOURCES

American Academy of Dermatology  https://www.aad.org 

American Autoimmune Related Diseases Association  http://www.aarda.org 

CANADIAN RESOURCES

Canadian Dermatology Association  https://www.dermatology.ca 

Canadian Institute for Health Information  https://www.cihi.ca 

References

Charles CA, Leon A, Banta MR, Kirsner RS. Etanercept for the treatment of refractory pyoderma gangrenosum: a brief series. Int J Dermatol. 2007;46(10):1095-1099.

Pyoderma gangrenosum. DermNet New Zealand website. Available at: https://www.dermnetnz.org/topics/pyoderma-gangrenosum. Updated September 2015. Accessed December 20, 2017.

Pyoderma gangrenosum. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T113752/Pyoderma-gangrenosum  . Updated November 21, 2016. Accessed December 20, 2017.

Reguiaï Z, Grange F. The role of anti-tumor necrosis factor-alpha therapy in Pyoderma gangrenosum associated with inflammatory bowel disease. Am J Clin Dermatol. 2007;8(2):67-77.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 11/2018
  • Update Date: 12/20/2014