Pyoderma Gangrenosum

  • Danya Reich
  • Corinna Eleni Psomadakis
  • Bobby Buka


Pyoderma gangrenosum is a rare inflammatory skin condition that causes painful, non-healing ulcers. The exact cause is unknown, but it is thought to be mediated by autoimmune processes, particularly involving dysregulated neutrophils. Over half the cases are associated with other autoimmune conditions, especially inflammatory bowel disease and rheumatoid arthritis. The ulcers of pyoderma gangrenosum develop rapidly, often at the site of a minor injury, and are characterized by a distinct purple border. Pyoderma gangrenosum is not infectious and antibiotics play no role in treatment. The mainstays of treatment are topical or systemic corticosteroids and analgesia. Recurrences are possible but may be prevented by controlling any underlying disease and avoiding injuries.


Pyoderma gangrenosum Violaceous borders Inflammatory bowel disease Crohn’s disease Inflammation Inflammatory disorder Neutrophilic infiltration Ulcer Ulceration Necrosis Non-healing ulcer 


  1. 1.
    Binus AM, Qureshi AA, Li VW, Winterfield LS. Pyoderma gangrenosum: a retrospective review of patient characteristics, comorbidities and therapy in 103 patients. Br J Dermatol. 2011;165(6):1244–50.CrossRefPubMedGoogle Scholar
  2. 2.
    DeFilippis EM, Feldman SR, Huang WW. The genetics of pyoderma gangrenosum and implications for treatment: a systematic review. Br J Dermatol. 2015;172(6):1487–97.CrossRefPubMedGoogle Scholar
  3. 3.
    Powell FC, Hackett BC, Wallach D. Chapter 33. Pyoderma gangrenosum. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s dermatology in general medicine. 8th ed. New York: McGraw-Hill; 2012. p. 371–9.Google Scholar
  4. 4.
    Agarwal A, Andrews JM. Systematic review: IBD-associated pyoderma gangrenosum in the biologic era, the response to therapy. Aliment Pharmacol Ther. 2013;38(6):563–72.CrossRefPubMedGoogle Scholar
  5. 5.
    Braswell SF, Kostopoulos TC, Ortega-Loayza AG. Pathophysiology of pyoderma gangrenosum (PG): an updated review. J Am Acad Dermatol. 2015;73(4):691–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Okhovat JP, Shinkai K. Pyoderma gangrenosum. JAMA Dermatol. 2014;150(9):1032.CrossRefPubMedGoogle Scholar
  7. 7.
    Ruocco E, Sangiuliano S, Gravina AG, Miranda A, Nicoletti G. Pyoderma gangrenosum: an updated review. J Eur Acad Dermatol Venereol. 2009;23(9):1008–17.CrossRefPubMedGoogle Scholar
  8. 8.
    Brooklyn T, Dunnill G, Probert C. Diagnosis and treatment of pyoderma gangrenosum. BMJ. 2006;333(7560):181–4.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Reichrath J, Bens G, Bonowitz A, Tilgen W. Treatment recommendations for pyoderma gangrenosum: an evidence-based review of the literature based on more than 350 patients. J Am Acad Dermatol. 2005;53(2):273–83.CrossRefPubMedGoogle Scholar

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© Springer International Publishing Switzerland 2017

Open Access This chapter is distributed under the terms of the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Authors and Affiliations

  • Danya Reich
    • 1
  • Corinna Eleni Psomadakis
    • 2
  • Bobby Buka
    • 3
  1. 1.Department of Family MedicineMount Sinai School of Medicine Attending Mount Sinai Doctors/Beth Israel Medical Group-WilliamsburgBrooklynUSA
  2. 2.School of Medicine Imperial College LondonLondonUK
  3. 3.Department of DermatologyMount Sinai School of MedicineNew YorkUSA

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