Phlebologie 2016; 45(05): 333-340
DOI: 10.12687/phleb2339-5-2016
Eduction: in Pictures
Schattauer GmbH

Pyoderma gangraenosum – from the right diagnostic investigations to targeted therapy

Article in several languages: English | deutsch
F. Jockenhöfer
1   Clinic for Dermatology, Venerology and Allergology, Universitätsklinikum Essen/Germany
,
J. Dissemond
1   Clinic for Dermatology, Venerology and Allergology, Universitätsklinikum Essen/Germany
› Author Affiliations
Further Information

Publication History

Received: 19 September 2016

Accepted: 20 September 2016

Publication Date:
22 December 2017 (online)

Summary

Pyoderma gangrenosum (PG) is a rarely diagnosed neutrophilic skin disorder that still remains a diagnosis of exclusion. Therefore, the diagnosis has to be done in the synopsis of typical clinical findings, patient’s history and exclusion of relevant differential diagnoses. There are numerous references to relevant comorbidities from the metabolic syndrome, rheumatoid arthritis and inflammatory bowel diseases. Of particular importance is the potential association of PG with (haematologic) neoplasms. Treatment of PG includes topical and systemic immuno-modulating or immuno-suppressant therapies. Most important are for topical as well as systemic treatments are glucocorticoids. All other treatments represent an off-label-use. Especially Cyclosporine and TNF-α-inhibitors demonstrated very good and promising clinical results. Accompanying modern moist wound-therapy concepts avoiding painful dressings and an analgesic therapy are recommended.