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Pyoderma gangrenosum is a rare, inflammatory skin disease where painful pustules or nodules become ulcers that progressively grow. [3] Pyoderma gangrenosum is not infectious. [3] Treatments may include corticosteroids, ciclosporin, infliximab, or canakinumab. [2] The disease was identified in 1930.
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).
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.
In superficial granulomatous pyoderma, ulcers typically have a clean base and vegetating borders, making them more superficial. Unlike pyoderma gangrenosum, superficial granulomatous pyoderma is more frequently associated with truncal involvement and is not always linked to underlying systemic disease. [2]
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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Comorbid ailments that may contribute to the formation of chronic wounds include vasculitis (an inflammation of blood vessels), immune suppression, pyoderma gangrenosum, and diseases that cause ischemia. [2] Immune suppression can be caused by illnesses or medical drugs used over a long period, like steroids. [2]