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Pyoderma gangrenosum ulcers demonstrate pathergy, that is, a worsening in response to minor trauma or surgical debridement. Significant care should be taken with dressing changes to prevent potentially rapid wound growth.
The inflammation and ulceration that occurs as a result of pathergy in pyoderma gangrenosum often responds to systemic steroid therapy. The pathergy reaction is a unique feature of Behçet's disease and, according to the International Study Group for Behcet's Disease, is among the major criteria required for the diagnosis.
Pyoderma gangrenosum is variably expressed, which means that it is not always present in all individuals with the disease. It presents as poorly healing ulcers with undermined edges. Pathergy is an important feature (this term refers to the tendency of ulcers to arise at points of injury).
Sweet syndrome (SS), or acute febrile neutrophilic dermatosis, [1] [2] is a skin disease characterized by the sudden onset of fever, an elevated white blood cell count, and tender, red, well-demarcated papules and plaques that show dense infiltrates by neutrophil granulocytes on histologic examination.
Additional causes include neutrophilic skin conditions such as pyoderma gangrenosum or Sweet's syndrome; vasculitic processes such as cryoglobulinemia; calciphylaxis (often seen in people with end-stage kidney disease but may also occur with medications such as warfarin); cancers such as squamous cell carcinoma (Marjolin's ulcer) or ...
Pyoderma means any skin disease that is pyogenic (has pus). These include superficial bacterial infections such as impetigo , impetigo contagiosa , ecthyma , folliculitis , Bockhart's impetigo , furuncle , carbuncle , tropical ulcer , etc. [ 1 ] [ 2 ] Autoimmune conditions include pyoderma gangrenosum .
Research into hormones and wound healing has shown estrogen to speed wound healing in elderly humans and in animals that have had their ovaries removed, possibly by preventing excess neutrophils from entering the wound and releasing elastase. [26] Thus the use of estrogen is a future possibility for treating chronic wounds.
A similar response occurs in pyoderma gangrenosum and Behcet's syndrome, and is referred to as pathergy. [3] Rarely Koebner phenomenon has been reported as a mechanism of acute myeloid leukemia dissemination. [4] Warts and molluscum contagiosum are often listed as causing a Koebner reaction, but this is by direct inoculation of viral particles. [3]
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