There are 4 main clinical patterns for pyoderma gangrenosum.
Clinical patterns of pyoderma gangrenosum:
(1) ulcerative
(2) pustular
(3) bullous
(4) vegetative
|
Pattern |
Clinical Features |
|
ulcerative |
progresses from an inflammatory pustule or nodule ulcerated with undermined border surrounded by relatively broad erythematous rim purulent base extremely painful and rapidly progressive |
|
pustular |
discrete painful papules that do not ulcerate erythematous border |
|
bullous |
superficial bullae that are painful erode with superficial ulceration may have rim of erythema |
|
vegetative |
superficial ulcer without undermining border base not purulent slowly progressive and chronic pain not a prominent feature may be come exophytic and vegetative |
|
Pattern |
Associated Disease |
|
ulcerative |
inflammatory bowel disease, monoclonal gammopathy, arthritis |
|
pustular |
acute exacerbation of inflammatory bowel disease |
|
bullous |
myeloproliferative or myelodysplastic disorder |
|
vegetative |
uncommon |
|
Pattern |
Therapy |
|
ulcerative |
aggressive systemic immunosuppression; may be difficult to control |
|
pustular |
treatment of underlying inflammatory bowel disease |
|
bullous |
systemic immunosuppression |
|
vegetative |
may respond to topical, intralesional or low intensity systemic therapy |
Specialty: Dermatology
