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.
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.
Pyoderma gangrenosum is more likely to occur in people who have other underlying medical conditions such as:
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.
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:
Talk with your doctor about the best treatment plan for you. Treatment options include:
Medications to treat pyoderma gangrenosum include:
You may need other medications to treat any underlying conditions
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.
There are no current guidelines to prevent pyoderma gangrenosum.
American Academy of Dermatology
American Autoimmune Related Diseases Association
Canadian Dermatology Association
Canadian Institute for Health Information
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: http://www.dynamed.com/topics/dmp~AN~T113752/P...erma-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.
Last reviewed December 2017 by EBSCO Medical Review Board Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.