Pyoderma gangrenosum

Pyoderma gangrenosum is a very common skin disease. People don’t know much about this disease, and we rarely see such a disease in normal times. This is a non-infectious skin ulcer. The clinical manifestations are pustules and furunculoid nodules. Some of them may also have hemorrhagic bullae. This disease is also a type of vasculitis. Once diagnosed, it must be treated in time.

Do you know about pyoderma gangrenosum? This skin disease has a great impact on patients. The most important thing is to treat it as early as possible. You also need to understand the cause of this skin disease. It is generally caused by some candida species, but it is not contagious.

The disease manifests as destructive necrotic, non-infectious skin ulcers, and clinically, furunculoid nodules, pustules or hemorrhagic bullae may also appear. In the case of early erythema nodosum or pustules, this disease can be attributed to vasculitis. Tender nodular erythema that is initially red, then turns blue in the center and eventually forms an ulcer. One or more vesicular pustules, similar to acne, folliculitis, transient acantholytic dermatosis, or dermatitis herpetiformis. The two types of skin lesions may appear at the same time or transform into each other. Skin lesions may occur on normal skin or at the site of pre-existing skin diseases. Painful ulcers with undermining margins and oozing foul-smelling yellow-green pus are diagnostic. Once the diagnosis is confirmed, high-dose oral corticosteroids are given.

Causes

It has been demonstrated that patients with this disease have a delayed response to DNCB, candida albicans, and streptokinase. This can explain why skin lesions can appear when there is a slight injury or damage when the reticuloendothelial system is extremely low. New lesions can also be caused by acupuncture. This hypersensitivity reaction is especially intense during the acute phase of the disease and near the lesions. It has been confirmed that there is a serum necrosis factor in guinea pig skin that can cause skin necrosis, but its specificity is unknown. The recognized evidence of immune mechanism defects is that many patients have gammaglobulin disease, ectopic protein disease, T cell disorder or phagocytic cell defect, etc.

Pathogenesis

The pathogenesis of this disease is unclear and may be a Shwartzman reaction. Many patients with this disease have a low or abnormal immune response, which indicates that this disease is related to a defect in the immune system. Some authors reported 4 cases of patients who showed no skin reaction.

Histopathology

Nonspecific changes manifest as sterile abscesses with venous and capillary thrombosis, hemorrhage, necrosis, and mast cell infiltration. Condensation is an important manifestation. Lymphocytic vasculitis is present in the active margins, suggesting that the vascular endothelium is an early target organ. Early skin lesions are similar to Behcet's disease and neutrophilic dermatitis. There are also some similarities with leukocytoclastic vasculitis. There are more polymorphonuclear leukocytes in the infiltrating cells, as well as epithelial cells and giant cells. Especially in chronic cases, monocytes are prominent, and there is even epithelioma-like hyperplasia. Pathological examination can rule out amebiasis and deep fungal infection.

Do you have some understanding of pyoderma gangrenosum? The occurrence of such skin diseases has a great impact on us. Some people don’t know what’s going on. Some skin diseases that occur in our daily lives should be able to attract our attention in time. Some skin diseases are still very harmful to us.