PG

Q: A 43-year-old male with an established history of ulcerative colitis is admitted to the ICU with Lower GI bleed requiring transfusion. On physical exam, chronic ulceration was noted on the lower extremity and diagnosed as Pyoderma gangrenosum (PG). PG, as the name suggests, is an infectious process causing gangrene.

A) True

B) False

Answer: B

Pyoderma gangrenosum (PG) is a misnomer as it is neither an infectious nor a gangrenous condition! The probability of this misnomer arises from its striking, infectious-like appearance.

PG is a neutrophilic dermatosis that presents as an inflammatory, ulcerative skin disorder. The most common presentation of PG is an inflammatory papule or pustule that progresses to a painful ulcer with a violaceous, undermined border and a purulent base. It may also present with bullous, vegetative, peristomal, and extracutaneous lesions.

Clinical Significance: It has high association with an underlying systemic diseases like inflammatory bowel disease, hematologic disorders, and arthritis.

#dermatology

References:

1. Maverakis E, Marzano AV, Le ST, Callen JP, Brüggen MC, Guenova E, Dissemond J, Shinkai K, Langan SM. Pyoderma gangrenosum. Nat Rev Dis Primers. 2020 Oct 8;6(1):81. doi: 10.1038/s41572-020-0213-x. PMID: 33033263.

2. Łyko M, Ryguła A, Kowalski M, Karska J, Jankowska-Konsur A. The Pathophysiology and Treatment of Pyoderma Gangrenosum-Current Options and New Perspectives. Int J Mol Sci. 2024 Feb 19;25(4):2440. doi: 10.3390/ijms25042440. PMID: 38397117; PMCID: PMC10889749.

3. Moltrasio C, Romagnuolo M, Tavoletti G, Maronese CA, Marzano AV. Pyoderma gangrenosum: pathogenetic mechanisms and their implications for treatment. Semin Immunopathol. 2025 Oct 23;47(1):38. doi: 10.1007/s00281-025-01064-7. PMID: 41128863; PMCID: PMC12549756.