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    Topical Medical Cannabis (TMC): A new treatment for wound pain-Three cases of Pyoderma Gangrenosum.
    J Pain Symptom Manage 2017 Aug 14. Epub 2017 Aug 14.
    Pain associated with integumentary wounds is highly prevalent yet it remains an area of significant unmet need within healthcare. Currently, systemically administered opioids are the mainstay of treatment. However, recent publications are casting opioids in a negative light given their high side effect profile, inhibition of wound healing, and association with accidental overdose, incidents that are frequently fatal. Read More

    Pyoderma gangrenosum in a patient with chronic granulomatous disease: A case report.
    Medicine (Baltimore) 2017 Aug;96(31):e7718
    1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
    Rationale: The simultaneous occurrence of pyoderma gangrenosum (PG) and chronic granulomatous disease (CGD) is uncommon and few cases have been reported worldwide.

    Patient Concerns: PG is a rare, chronic, ulcerative, neutrophilic skin disease of unknown etiology that requires immunosuppressive treatment. CGD belongs to Primary Immune Deficiencies in which the main defect lies in an inability of the phagocytic cells to generate superoxide making patients susceptible to serious, potentially life-threatening bacterial and fungal infections. Read More

    Skin diseases of the vulva: inflammatory, erosive-ulcerating and apocrine gland diseases, zinc and vitamin deficiency, vulvodynia and vestibulodynia.
    J Obstet Gynaecol 2017 Aug 1:1-12. Epub 2017 Aug 1.
    a Department of Dermatology , Bispebjerg Hospital , Copenhagen , Denmark.
    Chronic, inflammatory and ulcerating mucocutaneous diseases that can affect the vulvar area are reviewed: lichen sclerosus, lichen planus, plasma cell vulvitis, complex aphthosis, Behcet's disease, pyoderma gangrenosum, metastatic Crohn's disease, dyskeratotic skin diseases (Hailey-Hailey disease and Darier's disease), autoimmune bullous diseases (mucous membrane pemphigoid and pemphigus vulgaris) and hidradenitis suppurativa. Also, vulvodynia and vestibulodynia, zinc and vitamin B deficiency are described. Read More

    Pyoderma Gangrenosum in a Patient with X-Linked Agammaglobulinemia.
    Ann Dermatol 2017 Aug 21;29(4):476-478. Epub 2017 Jun 21.
    Department of Dermatology, Children's Hospital of Chongqing Medical University, Chongqing, China.
    X-linked agammaglobulinemia (XLA) is a primary immunodeficiency disorder caused by germline mutations of B-cell tyrosine kinase (BTK) gene. It is characterized by decreased serum immunoglobulins levels and circulating mature B cells. This defect in humoral immunity leads to increased susceptibility to infection. Read More

    Skin Manifestations of Rheumatoid Arthritis, Juvenile Idiopathic Arthritis, and Spondyloarthritides.
    Clin Rev Allergy Immunol 2017 Jul 27. Epub 2017 Jul 27.
    Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
    Extra-articular manifestations of rheumatoid arthritis, juvenile idiopathic arthritis, and various spondyloarthritides including psoriatic arthritis, ankylosing spondylitis, reactive arthritis, and inflammatory bowel disease-associated spondyloarthritis often involve the skin and may occur before or after diagnosis of these rheumatic diseases. Cutaneous manifestations encompass a wide range of reactions that may have a notable negative impact not only on the physical but especially on the emotional and psychosocial well-being of these patients. Several cutaneous manifestations have been related to rheumatoid arthritis such as subcutaneous nodules including classical rheumatoid nodules, accelerated rheumatoid nodulosis, and rheumatoid nodulosis; vascular disorders like rheumatoid vasculitis, livedo racemosa, and Raynaud's phenomenon; and neutrophilic and/or granulomatous diseases like pyoderma gangrenosum, Sweet's syndrome, rheumatoid neutrophilic dermatitis, interstitial granulomatous dermatitis with arthritis, as well as palisaded neutrophilic and granulomatous dermatitis. Read More

    Intravenous Immunoglobulin as Adjunct Therapy for Refractory Pyoderma Gangrenosum: Systematic Review of Cases and Case Series.
    Br J Dermatol 2017 Jul 25. Epub 2017 Jul 25.
    Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
    Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis. Treatment regimens for refractory cases are non-standardized. Intravenous immunoglobulin (IVIG) is an emerging treatment with reported success, but the efficacy of IVIG for PG is unknown. Read More

    Inflammatory Joint Disorders and Neutrophilic Dermatoses: a Comprehensive Review.
    Clin Rev Allergy Immunol 2017 Jul 22. Epub 2017 Jul 22.
    Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Unità Operativa di Dermatologia, Università degli Studi di Milano, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
    Rheumatoid arthritis and spondyloarthritis are inflammatory joint disorders with an autoimmune pathogenesis and systemic involvement. The skin is one of the most frequently affected extraarticular sites with a number of manifestations or distinct diseases, including common conditions, such as rheumatoid nodules and psoriasis, and rare diseases like neutrophilic dermatoses. The latter are clinically characterised by polymorphic lesions, including pustules, bullae, abscesses, papules, nodules, plaques and ulcers, and histologically by neutrophil-rich inflammatory infiltrates. Read More

    Dysregulation of inflammatory gene expression in lesional and non-lesional skin of patients with pyoderma gangrenosum.
    Br J Dermatol 2017 Jul 22. Epub 2017 Jul 22.
    Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, 23298.
    Pyoderma gangrenosum (PG) is an inflammatory skin condition that often presents as chronic ulcers. It is often idiopathic but can be associated with systemic conditions(1) . Our recent publications(1,2) highlight the need for better characterization of the molecular understanding of PG to improve diagnostic accuracy and targeted therapy. Read More

    Postoperative Pyoderma Gangrenosum in Children: The Case Report of a 13-Year-Old Boy With Pyoderma Gangrenosum After Hip Reconstruction Surgery and a Review of the Literature.
    J Pediatr Orthop 2017 Sep;37(6):e379-e383
    *Department of Children's Orthopedics, Hospital for Children Munich-Schwabing, Munich †BG Trauma Center Murnau, Murnau, Germany.
    Background: Postoperative pyoderma gangrenosum (PG) is a neutrophilic dermatosis and pathergic reaction at surgical sites. Reports of children with postoperative PG are rare in the literature.

    Methods: We report the case of a 13-year-old boy without any known preexisting illnesses, who developed severe systemic response and wound deterioration after elective hip reconstruction surgery. Read More

    Drug management of neutrophilic dermatoses.
    Expert Rev Clin Pharmacol 2017 Jul 27:1-10. Epub 2017 Jul 27.
    b UOC Dermatologia, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti , Università Degli Studi di Milano , Milan , Italy.
    Introduction: Neutrophilic dermatoses are a heterogenous group of chronic, cutaneous inflammatory conditions characterized by the accumulation of neutrophils in the skin and by systemic inflammation. Neutrophilic dermatoses can be idiopathic or associated with other inflammatory or systemic diseases, including the group of the hereditary, autoinflammatory syndromes. Clinical management is challenging, due to limited clinical evidence and lack of clinical practice guidelines. Read More

    A Case of Ischemia-Induced Perianal Ulceration Mimicking Pyoderma Gangrenosum.
    Skinmed 2017 1;15(3):235-237. Epub 2017 Jun 1.
    Department of Dermatology, Antrim Area Hospital, Antrim, Northern Ireland.
    A 68-year-old woman, with a 75-pack-year smoking history and a history of chronic excess alcohol intake, presented with a 5-week history of worsening perianal pain and ulceration. She recently had an inpatient admission with back pain and urinary tract infection during which she developed diarrhea and fecal incontinence. Initially, the perianal ulceration was diagnosed as severe irritant contact dermatitis and treated with barrier creams and topical clobetasone 17-butyrate 0. Read More

    Postoperative Pyoderma Gangrenosum Following Video-Assisted Thoracic Surgery.
    J Drugs Dermatol 2017 Jul;16(7):711-713

    Pyoderma gangrenosum (PG) is a neutrophilic, ulcerative dermatosis that can develop at sites of cutaneous trauma, including surgical incisions, a phenomenon known as pathergy. The characteristic lesion is a painful, rapidly expanding ulceration with a violaceous undermined border.1 A biopsy taken from the expanding violaceous border shows predominantly neutrophilic dermal inflammation with neutrophilic abscess formation. Read More


    A Comprehensive Review of Neutrophilic Diseases.
    Clin Rev Allergy Immunol 2017 Jul 7. Epub 2017 Jul 7.
    Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy.
    Neutrophilic dermatoses are a group of conditions characterized by the accumulation of neutrophils in the skin and clinically presenting with polymorphic cutaneous lesions, including pustules, bullae, abscesses, papules, nodules, plaques and ulcers. In these disorders, the possible involvement of almost any organ system has lead to coin the term 'neutrophilic diseases'. Neutrophilic diseases have close clinicopathological similarities with the autoinflammatory diseases, which present with recurrent episodes of inflammation in the affected organs in the absence of infection, allergy and frank autoimmunity. Read More

    Ulcerative Pyoderma Gangrenosum and Leukocytoclastic Vasculitis in a Hypothyroid Woman: A Case Report.
    Wounds 2017 Jun;29(6):E43-E47
    Department of Dermatology, SMS Medical College and Hospital, Jaipur, Rajasthan, India.
    Background: Skin ulcers, especially of the lower extremities, encompass a myriad of causes that a clinician must analyze. Case Re- port. A 45-year-old hypothyroid woman presented with a 6-year history of recurrent widespread eruptions of rashes and ulcers on her skin. Read More

    Dosing considerations in the use of the direct oral anticoagulants in the antiphospholipid syndrome.
    J Clin Pharm Ther 2017 Jun 27. Epub 2017 Jun 27.
    University of Colorado at Denver - Anschutz Medical Campus, Aurora, CO, USA.
    What Is Known And Objectives: At least four prospective trials have been initiated investigating the direct oral anticoagulants in the antiphospholipid syndrome. Preliminary reports have supported their use in patients with a history of venous thrombosis and a target INR of 2-3, but there have also been reports of failure of these agents in the antiphospholipid syndrome. The objective is to present a case report that illustrates there may be important dosing issues when considering the use of these agents in patients with the antiphospholipid syndrome. Read More

    Skin Manifestations of Inflammatory Bowel Disease.
    Clin Rev Allergy Immunol 2017 Jun 23. Epub 2017 Jun 23.
    Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
    Inflammatory bowel disease (IBD) with its two main subtypes Crohn's disease and ulcerative colitis is not restricted to the gastrointestinal tract. Indeed, so-called extraintestinal manifestations (EIMs) are frequent and considerably affect morbidity and mortality. The prevalence of EIMs ranges from 6 to 47%. Read More

    [Chronic leg ulcers].
    Hautarzt 2017 Aug;68(8):614-620
    Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland.
    Chronic wounds often manifest as ulcers on the lower legs. The main causes of chronic leg ulcers are chronic venous insufficiency and/or peripheral arterial occlusive disease in approximately 80% of all patients. However, there are also numerous other potentially relevant factors which can cause or almost impede the healing of chronic leg ulcers. Read More

    Pyoderma gangrenosum and underlying diseases in Japanese patients: A regional long-term study.
    J Dermatol 2017 Jun 21. Epub 2017 Jun 21.
    Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
    Pyoderma gangrenosum (PG) is a chronic inflammatory disease of unknown cause that presents as an inflammatory and ulcerative disorder of the skin. PG is often associated with an underlying systemic disease. However, the frequencies of the underlying diseases are unclear in Japanese patients. Read More

    Pyoderma gangrenosum: Classic and emerging therapies.
    Med Clin (Barc) 2017 Jun 16. Epub 2017 Jun 16.
    Departamento de Dermatología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address:
    Pyoderma gangrenosum is an ulceronecrotising dermatosis that represents a challenge for any clinician, not only for its ability to mimic other dermatoses but also for its lack of response to treatment. During the past year, there have been new studies about the efficacy of standard therapies, such as cyclosporine and systemic corticosteroids. These studies showed that classic treatment was comparable, but they are insufficient as monotherapy. Read More

    Haematological involvement associated with a mild autoinflammatory phenotype, in two patients carrying the E250K mutation of PSTPIP1.
    Clin Exp Rheumatol 2017 Jun 19. Epub 2017 Jun 19.
    Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy.
    Objectives: Hyperzincaemia/hypercalprotectinemia (Hz/Hc) syndrome is a recently described condition caused by a specific de novo mutation (E250K) affecting PSTPIP1 gene. It has a phenotype distinct from classical pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome that includes severe systemic and cutaneous inflammation, hepatosplenomegaly, arthritis without sequelae, pancytopenia and failure to thrive.

    Methods: We describe an 8-year-old boy who presented recurrent right knee swelling mimicking septic arthritis and persistent bone marrow involvement, without cutaneous involvement. Read More

    PASH syndrome a disease with genetic heterogeneity.
    Br J Dermatol 2017 Jun 18. Epub 2017 Jun 18.
    Department of Dermatology and Venereology, University Hospital of Brest.
    PASH syndrome is a clinical entity associating pyoderma gangrenosum (PG), severe acne and hidradenitis suppurativa (HS)(1) . Absence of pyogenic sterile arthritis (PA) distinguishes PASH syndrome from PAPASH and PAPA syndromes which associate PA in combination with PG, severe acne with or without HS, respectively(2,3) . Mutations in PSTPIP1 (proline-serine-threonine-phosphatase interacting protein 1) gene were identified in patients with PAPA and PAPASH syndromes, although genetic heterogeneity was observed in PAPA syndrome(2,3) . Read More

    Drug-Induced Pyoderma Gangrenosum: A Review.
    Am J Clin Dermatol 2017 Jun 17. Epub 2017 Jun 17.
    York Dermatology Centre, Toronto, ON, Canada.
    Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that may be caused by an adverse drug reaction. We discuss the clinical presentation and outcomes of 52 cases of drug-induced PG reported to date in the literature. We conducted our literature search for case reports of drug-induced PG using keywords on PubMed and Medical Subject Heading (MeSH) terms on MEDLINE and EMBASE. Read More

    Saddle-nose and bilateral cauliflower ear deformities with pyoderma gangrenosum-like ulcers, cavitary pulmonary lesions, digital gangrene and pulselessness in a young female.
    BMJ Case Rep 2017 Jun 15;2017. Epub 2017 Jun 15.
    Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India.
    We report a young female who presented with saddle-nose and bilateral cauliflower ear deformities along with pyoderma gangrenosum-like ulcers, digital gangrene and pulselessness. Subsequently, she was found to have bilateral conductive hearing loss, a corneal opacity, mild aortic regurgitation and radiological evidence of cavitary changes in lungs and aortoarteritis. Our patient had a constellation of symptoms which posed a diagnostic challenge. Read More

    Bullous Pyoderma Gangrenosum Associated with Hairy Cell Leukemia and Its Complete Response to Cladribine Therapy.
    Indian J Hematol Blood Transfus 2017 Jun 11;33(2):273-275. Epub 2016 Aug 11.
    Department of Internal Medicine and Hematology, 4th Floor, Nehru Hospital, PGIMER, Chandigarh, India.
    Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis seen in association with systemic disorders including hematologic malignancies. Hairy cell leukemia (HCL) however, is an unusual association of PG. We describe a 49-year old lady who presented to our hematology clinic with easy fatiguability and ulcerative skin lesions of 6 months duration. Read More

    Efficacy of cytapheresis for remission induction and dermatological manifestations of ulcerative colitis.
    J Clin Apher 2017 Jun 5. Epub 2017 Jun 5.
    Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan.
    Background: In ulcerative colitis (UC) patients, cytapheresis depletes elevated and activated leucocytes, which are known to release inflammatory cytokines including tumor necrosis factor (TNF)-α. Further, there are UC patients who develop erythema nodosum (EN) or pyoderma gangrenosum (PG) as extra-intestinal manifestations of UC.

    Methods: Between 2008 and 2015, 181 consecutive patients with active UC received cytapheresis with either a granulocyte and monocyte apheresis (GMA) column or with a leucocyte removal filter (LCAP) as remission induction therapy. Read More

    [Evidence of compression therapy].
    Hautarzt 2017 Aug;68(8):625-631
    Klinik- und Poliklinik für Haut- und Geschlechtskrankheiten, Universitätsmedizin Greifswald, F.-Sauerbruchstr., 17475, Greifswald, Deutschland.
    Background: Medical compression therapy is widely used to treat phlebologic diseases. Compression bandages as well as compression stockings are used. Compression has been identified to be an effective conservative therapy for the healing of venous ulcers and other indications. Read More

    Cutaneous Manifestations of Medium- and Large-Vessel Vasculitis.
    Clin Rev Allergy Immunol 2017 May 26. Epub 2017 May 26.
    Université Pierre et Marie Curie-Paris VI, Assistance Publique-Hôpitaux de Paris, Service de Dermatologie-Allergologie, Hôpital Tenon, 4 rue de la Chine, 75020, Paris, France.
    Dermatologic manifestations are observed in almost all systemic vasculitides, even in large-and medium-vessel vasculitides, although such vessels are not found in the skin. Cutaneous manifestations may be related to a direct skin localization of the systemic vasculitis or a non-specific process associated with the vasculitis. According to the 2012 International Chapel Hill consensus, the two major variants of large-vessel vasculitides are Takayasu arteritis and giant-cell arteritis. Read More

    The Pathergy Test as a Diagnostic Tool.
    Skinmed 2017 1;15(2):97-104. Epub 2017 Apr 1.
    Dermatology Unit, Kaplan Medical Center, Rechovot, Israel.
    The pathergy test produces a nonspecific hyperreactive lesion in Behçet's disease (BD), a finding that has been known since 1937. Pathergy refers to the development of new skin lesions or the aggravation of existing ones after trivial trauma. In clinical practice, the pathergy test induces a skin response by needleprick, with positive reactions manifesting as a papule or pustule developing by 48 hours. Read More

    [Unusual association between auto-immune hepatitis and pyoderma gangrenosum. A case report].
    Rev Med Brux 2017 ;38(2):95-98
    Département de Médecine interne générale, Groupe Jolimont.
    Pyoderma gangrenosum is an uncommon neutrophilic dermatosis that presents as an inflammatory and ulcerative disorder of the skin. This entity is associated with systemic diseases and autoimmune diseases but exceptionally with autoimmune hepatitis. We report the case of a 40 year-old woman diagnosed with type 1 autoimmune hepatitis 12 years earlier and admitted for the appearance of an ulcerative lesion in the left leg. Read More

    [Pathergic postsurgical-induced Pyoderma gangrenosum].
    Rev Med Liege 2017 May;72(5):227-232
    Service de Chirurgie Plastique, Esthétique et Reconstructrice, Clinique Saint-Vincent de Rocourt (CHC), Liège, Belgique.
    Pyoderma gangrenosum (PG) is a rare pustular and ulcerative inflammatory disease belonging to the group of neutrophilic dermatoses. It is frequently associated with systemic immune diseases. In this context the PG can be exceptionally triggered by tissue trauma such as surgery (pathergy). Read More

    T helper type 1-related molecules as well as interleukin-15 are hyperexpressed in the skin lesions of patients with pyoderma gangrenosum.
    Clin Exp Immunol 2017 Sep 23;189(3):383-391. Epub 2017 Jun 23.
    Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Florence, Italy.
    Pyoderma gangrenosum (PG) is a rare, immune-mediated skin disease classified into the group of neutrophilic dermatoses. Although a number of studies confirmed the central role of innate immunity, only few studies have investigated the possible contributing role of acquired immunity. In particular, no reports concerning T helper type 1 (Th1) and Th2 cells are available as yet. Read More

    Pyoderma Gangrenosum after Deep Inferior Epigastric Perforator Breast Reconstruction: Systematic Review and Case Report.
    Plast Reconstr Surg Glob Open 2017 Apr 21;5(4):e1239. Epub 2017 Apr 21.
    Division of Plastic and Reconstructive Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, N.H.
    Background: Pyoderma gangrenosum (PG) is a rare skin disorder of the neutrophilic dermatoses spectrum that can mimic wound infections in surgical patients. PG after breast surgery has been reported but in limited amounts in autologous breast reconstruction patients. We present the first case of PG after a delayed bilateral deep inferior epigastric perforator flap breast reconstruction in the setting of systemic disease along with a systematic review. Read More

    [Penile Tuberculosis : A Case Report].
    Hinyokika Kiyo 2017 Apr;63(4):163-167
    The Department of Infection Control Team, Osaka Police Hospital.
    A 66-year-old man presented with a chief complaint of glans penis pain, induration, and discharge of pus. He was prescribed a course of antibiotics, but the condition persisted despite treatment. Thus, we differrentially diagnosed the patient with penile tuberculosis and pyoderma gangrenosum, and performed a biopsy of the penis. Read More

    Pyoderma gangrenosum with pathergy: A potentially significant complication following breast reconstruction.
    J Plast Reconstr Aesthet Surg 2017 Jul 12;70(7):884-892. Epub 2017 Apr 12.
    Department of Dermatology, Middlemore Hospital, Counties Manukau District Health Board, 100 Hospital Road, Private Bag 93311, Otahuhu, Auckland, New Zealand; Department of Medicine, Faculty of Medicine and Health Sciences, The University of Auckland, New Zealand. Electronic address:
    The failure of postoperative surgical site infection to resolve after appropriate antibiotic therapy should alert the clinician to other diagnoses. Pyoderma gangrenosum (PG) is an inflammatory neutrophilic dermatosis that is typically characterized by necrotizing ulceration. PG can be exacerbated by minor trauma leading to exaggerated skin injury, a condition known as pathergy. Read More

    Acute Cutaneous Necrosis: A Guide to Early Diagnosis and Treatment.
    J Cutan Med Surg 2017 May 1:1203475417708164. Epub 2017 May 1.
    4 University of Missouri Kansas City, Department of Internal Medicine, Kansas City, MO, USA.
    Acute cutaneous necrosis is characterised by a wide range of aetiologies and is associated with significant morbidity and mortality, warranting complex considerations in management. Early recognition is imperative in diagnosis and management of sudden gangrenous changes in the skin. This review discusses major causes of cutaneous necrosis, examines the need for early assessment, and integrates techniques related to diagnosis and management. Read More

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