What is pyoderma gangrenosum?
Pyoderma gangrenosum is a chronic inflammatory skin disease of unknown cause that causes large sores to form on the skin.
How common is pyoderma gangrenosum?
Pyoderma gangrenosum is rare. It affects women slightly more often than men. It occurs most often between the ages of 20 to 50 years. Infants or adolescents account for fewer than 4 percent of cases. Please discuss with your doctor for further information.
What are the symptoms of pyoderma gangrenosum?
Pyoderma gangrenosum usually starts with a small, red bump on your skin, which may resemble a spider bite. Within days, this bump can develop into a large, painful open sore.
The ulcer usually appears on your legs, but may develop anywhere on your body. Sometimes it appears around surgical sites. If you have several ulcers, they may grow and merge into one larger ulcer.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes pyoderma gangrenosum?
Pyoderma gangrenosum isn’t infectious or contagious, but no one knows exactly what causes it. It’s often associated with autoimmune diseases such as ulcerative colitis, Crohn’s disease and rheumatoid arthritis. And some studies indicate that it may have a genetic component.
If you have pyoderma gangrenosum, new skin trauma, such as a cut or puncture wound, may trigger new ulcers.
What increases my risk for pyoderma gangrenosum?
There are many risk factors for pyoderma gangrenosum, such as:
- Your age and sex. The condition is slightly more common among women. And it usually occurs between the ages of 40 and 50, though it can appear at any age.
- Having inflammatory bowel disease. People with a digestive tract disease such as ulcerative colitis or Crohn’s disease are at increased risk of pyoderma gangrenosum.
- Having rheumatoid arthritis. People with rheumatoid arthritis are at increased risk of pyoderma gangrenosum.
- Having blood cancer. People with blood disorders (hematologic malignancies) are at increased risk of pyoderma gangrenosum.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is pyoderma gangrenosum diagnosed?
No specific diagnostic tests exist for pyoderma gangrenosum. Diagnosis is made by excluding similar disorders based upon a thorough clinical evaluation, a detailed a patient history and a variety of tests such as surgical removal and microscopic evaluation of affected tissue (biopsy).
How is pyoderma gangrenosum treated?
Treatment of pyoderma gangrenosum is aimed at reducing inflammation, controlling pain and promoting wound healing. Depending on the size and depth of your skin ulcers, it can take weeks or months for them to heal, often with scarring. Treatment may also involve a hospital stay or specialized wound care in a burn treatment center.
Even after successful treatment, it’s common for new wounds to develop.
Corticosteroids. High doses of corticosteroids are the mainstay of pyoderma gangrenosum treatment. These drugs may be applied to the skin, injected into the wound or taken by mouth (prednisone). Using corticosteroids for a long time or in high doses may cause serious side effects, including bone loss and an increased risk of infection. To help limit side effects, your doctor will gradually reduce your dose once your wounds begin to heal.
Drugs that suppress the immune system. Another way to limit your prednisone dose is to also use drugs that suppress the immune system, such as calcineurin inhibitors (tacrolimus), cyclosporine, mycophenolate and infliximab. Depending on the type of drug used, it may be applied to the wounds, injected or taken by mouth.
Pain medication. Depending on the extent of your wounds, you may benefit from pain medication, especially when dressings are being changed.
In addition to applying medicine directly to your wounds, your doctor or wound care specialist will cover them with a moist (not wet or dry) dressing and, perhaps, an elasticized wrap. You may be asked to keep the affected area elevated.
Follow your doctor’s instructions carefully regarding wound care. This is especially important because many of the oral medications prescribed for pyoderma gangrenosum suppress your immune system, which increases your risk of infection.
Because pyoderma gangrenosum can be made worse by cuts to the skin, surgery to remove dead tissue is not usually considered a good treatment option. Trauma to the skin may worsen existing ulcers or trigger new ones.
If the ulcers on your skin are large and need help with healing, your doctor might suggest a skin graft. In this procedure, the surgeon attaches a piece of skin or synthetic skin over the open sores. This is attempted only after the wound inflammation has gone and the ulcer has started healing.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage pyoderma gangrenosum?
With treatment you’re likely to recover from pyoderma gangrenosum. You may feel depressed if the process takes a long time and is painful. Or you may feel stressed about the possibility of recurrence or about how your skin looks. You may find it helpful to talk with a counselor, medical social worker or other people who have or had pyoderma gangrenosum.
If you want counseling or support, ask your doctor for a referral to a mental health professional or contact information for a support group in your area.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Pyoderma gangrenosum. https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/symptoms-causes/syc-20350386. Accessed December 6, 2017.
Pyoderma Gangrenosum. https://rarediseases.org/rare-diseases/pyoderma-gangrenosum/. Accessed December 6, 2017.
Pyoderma Gangrenosum. http://www.merckmanuals.com/home/skin-disorders/hypersensitivity-and-inflammatory-skin-disorders/pyoderma-gangrenosum. Accessed December 6, 2017.
Review Date: December 4, 2017 | Last Modified: December 8, 2017