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Diagnosis of Pyoderma Gangrenosum & Risk Factors

October 18, 2011 2 Comments

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Pyoderma gangrenosum is a rare but serious ulcerating skin disease causing painful ulcers on the legs and other parts of the body. Although pyoderma gangrenosum can affect individuals of any age, it is most common in people in their 40s and 50s. It tends to be associated with inflammatory conditions, including ulcerative colitis, Crohn’s disease, rheumatoid arthritis, and hepatitis.

Diagnosis of pyoderma gangrenosum can be problematic as no specific diagnostic features can be identified from biopsies and no laboratory marker is available. Diagnosis is therefore generally based on clinical findings and through the exclusion of other possible disorders. To improve accuracy of diagnosis, it is important to have a thorough understanding of the patient’s medical history so that risk factors for pyoderma gangrenosum may be identified.(1-3)

Differential Diagnosis

There are five common disease categories which may imitate the appearance of pyoderma gangrenosum.(1) Ruling out any of these conditions can point to a diagnosis of pyoderma gangrenosum.

  • Infections –  bacterial, mycobacterial, fungal, viral, parasitic
  • Malignancy –  squamous cell carcinoma, cutaneous lymphoma
  • Vascular Ulceration –  venous or arterial disease, antiphospholipid syndrome
  • Systemic Conditions –  systemic lupus erythematosis, rheumatoid arthritis, Behçet’s disease, Wegner’s granulomatosis
  • Sweet’s Syndrome – Sweet’s syndrome, characterized by the sudden onset of fever and an erythematous, papular eruption, in particular can be hard to differentiate from pyoderma gangrenosum. Sweet’s syndrome and pyoderma can coexist in the same patient as they are both neutrophilic dermatoses.(1)

Because the diagnosis of pyoderma gangrenosum can be so challenging, and because the consequences of a late or missed diagnosis can be so devastating, it is worth developing a good understanding of the signs of this condition, particularly among patients with inflammatory disorders.  The opportunity to study conditions such as pyoderma gangrenosum in greater depth can be gained by pursuing additional professional development, including wound certification.

Learn More With Our Wound Care Education Options

Interested in learning more about wound care and certification? Browse through our wound care certification courses for information on our comprehensive range of education options to suit healthcare professionals across the full spectrum of qualifications and experience.

References

  1. Brooklyn T, Dunnill G, Probert C. Diagnosis and treatment of pyoderma gangrenosum. BMJ. 2006;333:181-4.
  2. Wollina U. Pyoderma gangrenosum–a review. Orphanet J Rare Dis. 200715;2:19.
  3. Jackson M, Callen JP. Pyoderma gangrenosum.  Medscape March 2010 (available at http://emedicine.medscape.com/article/1123821-overview#a0199).

Categories: Miscellaneous Wounds

About the Author

Laurie Swezey's avatar

Laurie Swezey, founder and president of WoundEducators.com, has been a Registered Nurse for more than a quarter century, with most of those years dedicated to wound treatment. Ms. Swezey is a Certified Wound Care Nurse and a Certified Wound Specialist.

Reader Interactions

Comments

  1. Anonymous says

    December 8, 2010 at 9:24 pm

    does it require a certain amount to enrol in this program?for how long do you require us to follow these course until certified?thank you….

    Reply
  2. Anonymous says

    December 29, 2011 at 8:46 pm

    Hi Corazon, When you are ready to advance your career,  WoundEducators.com  can assist you in achieving your objective.  The woundeducators.com online interactive educational programs are convenient and you can complete the woundeducators.com course without travel expense and missed time work.   Online learning also allows you to proceed at your own pace, which improves learning and retention. 

     

    Please visit http://www.woundeducators.com for additional information.   In addition, the following presentation provides a brief overview of our program: Preview

    Feel free to contact me with additional questions.

     

    Best Regards,

     

    Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

    President WoundEducators.com

    Reply

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