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    1 OF 57

    Pyoderma gangrenosum in a pregnant patient: A case report and literature review.
    J Obstet Gynaecol Res 2017 Apr;43(4):775-778
    Department of Obstetrics and Gynecology, Toho University Medical Center-Sakura Hospital, Chiba, Japan.
    Pyoderma gangrenosum (PG) is a rare ulcerative skin disease that usually starts as a pustular lesion and rapidly progresses to a painful ulcer with undermined violaceous borders. The occurrence of PG during pregnancy is uncommon. We describe a case of a pregnant patient with PG who was diagnosed as having ulcerative colitis after delivery. Read More

    Recalcitrant cases of pyoderma gangrenosum, responding dramatically to systemic tacrolimus.
    G Ital Dermatol Venereol 2017 Jun;152(3):308-310
    Department of Rheumatology, Shiraz University of Medical Sciences, Shiraz, Iran.
    Pyoderma gangrenosum (PG) is an uncommon ulcerative cutaneous disease, without any well-known specific and effective treatment. Here we report two patients with severe recalcitrant perineal pyoderma gangrenosum, successfully treated with low dose systemic tacrolimus. Tacrolimus can be a safe effective drug in the management of recalcitrant PG. Read More

    Postsurgical Pyoderma Gangrenosum Following Carpal Tunnel Release: A Rare Disease Following a Common Surgery.
    Eplasty 2017 21;17:e10. Epub 2017 Mar 21.
    Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, IL.
    Objective: Postsurgical pyoderma gangrenosum is a rare but potentially devastating condition for surgical patients. While pyoderma gangrenosum has 2 subtypes, typical and atypical, each can be further classified by its heralding features. These include ulcerative, pustular, bullous, and vegetative. Read More

    Ciclosporin compared to prednisolone therapy for patients with pyoderma gangrenosum: cost-effectiveness analysis of the STOP GAP trial.
    Br J Dermatol 2017 Apr 9. Epub 2017 Apr 9.
    Centre of Evidence Based Dermatology, University of Nottingham, NG7 2NR, UK.
    Background: Pyoderma gangrenosum (PG) is a painful, ulcerating skin disease with poor evidence for management. Prednisolone and ciclosporin are the most commonly used treatments, although not previously compared within a randomised controlled trial (RCT) OBJECTIVES: To compare the cost-effectiveness of ciclosporin and prednisolone-initiated treatment for patients with PG.

    Methods: Quality-of-life (EuroQoL EQ-5D-3L) and resource data were collected as part of the STOP-GAP trial: a multicentre, parallel-group, observer-blind RCT. Read More

    Clinical update on inflammasomopathies.
    Int Immunol 2017 Apr 6. Epub 2017 Apr 6.
    Department of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey.
    Inflammasomes are important elements of the innate immune defense. The most common autoinflammatory syndromes, as well a number of rare ones, are due to hereditary defects in the inflammasomes, hence are called inflammasomopathies. The recent clinical advances in these diseases will be reviewed, with special emphasis on reflecting the international collaborative work in the field. Read More

    Postsurgical Pyoderma Gangrenosum Versus Necrotizing Fasciitis: Can We Spot the Difference?
    Ann Plast Surg 2017 May;78(5):582-586
    From the Department of Plastic Surgery, Countess of Chester Hospital, Chester, PA.
    Background: Pyoderma gangrenosum is a rare noninfectious cutaneous disease characterized by expanding areas of skin ulceration around necrotic centers with purulent debris. Exceptionally, it can be precipitated by surgery alone, and this entity has been described as postsurgical pyoderma gangrenosum (PSPG). Cases of PSPG in the literature are rare. Read More

    A case of breakthrough Candida parapsilosis fungemia during micafungin therapy for a Candida glabrata bloodstream infection.
    Med Mycol Case Rep 2017 Jun 23;16:1-3. Epub 2017 Mar 23.
    Department of Infectious Diseases, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo 187-8510, Japan.
    We describe a case of breakthrough Candida parapsilosis fungemia in an 80-year-old woman with pyoderma gangrenosum and rheumatoid arthritis. C. parapsilosis was detected in blood culture while the patient was treated with micafungin for a Candida glabrata bloodstream infection. Read More

    Dramatic resolution of disseminated pyoderma gangrenosum associated with monoclonal gammopathy after therapy with bortezomib and dexamethasone.
    Int Wound J 2017 Mar 29. Epub 2017 Mar 29.
    Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain.
    Pyoderma gangrenosum (PG) is an uncommon inflammatory and ulcerative skin disorder, which is commonly associated with systemic conditions such as inflammatory bowel disease, arthritis and haematological malignancies. It is widely stated that control of the underlying diseases may lead to resolution of PG. However, standard of care dictates that patients suffering with monoclonal gammopathy of undetermined significance or smouldering multiple myeloma (MM) should not receive therapy unless they progress to symptomatic MM. Read More

    Autoinflammatory syndromes associated with hidradenitis suppurativa and/or acne.
    Int J Dermatol 2017 Mar 27. Epub 2017 Mar 27.
    Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
    Autoinflammatory syndromes associated with hidradenitis suppurativa (HS) and/or acne are rare but potentially debilitating disorders if not diagnosed and treated correctly. They share a common pathogenesis involving a dysregulated innate immune system with abnormal interleukin (IL)-1 signaling leading to sterile neutrophilic inflammation. The clinical features are recurrent episodes of fever, painful arthritis, and skin lesions consistent with HS, acne, and pyoderma gangrenosum (PG) accompanied by elevated systemic inflammatory markers in blood. Read More

    Successful Treatment of Autoimmune Disease-Associated Pyoderma Gangrenosum With the IL-1 Receptor Antagonist Anakinra: A Case Series of 3 Patients.
    J Clin Rheumatol 2017 Apr;23(3):181-183
    Department of Rheumatology, Princess of Wales Hospital, Bridgend, United Kingdom Department of Dermatology, Princess of Wales Hospital, Bridgend, United Kingdom Department of Dermatology, Neath Port Talbot Hospital, Port Talbot, United Kingdom Department of Rheumatology, Neath Port Talbot Hospital, Port Talbot, United Kingdom Department of Dermatology, Neath Port Talbot Hospital, Port Talbot, United Kingdom Department of Rheumatology, Princess of Wales Hospital, Bridgend, United Kingdom.

    Pyoderma gangrenosum: clinical characteristics, associated diseases, and responses to treatment in a retrospective cohort study of 31 patients.
    Int J Dermatol 2017 Apr;56(4):386-391
    Chair of Dermatology, Universidad de Buenos Aires, Buenos Aires, Argentina.
    Objective: The aim of this study was to describe the clinical characteristics of patients with pyoderma gangrenosum (PG) and to evaluate the association between these characteristics, the treatment followed, and the patient responses, relapses, and mortality rates.

    Material And Methods: This retrospective cohort study identified adults diagnosed with pyoderma gangrenosum over the duration of 10 years.

    Results: Thirty-one patients were evaluated; 58% were women and 55% were older than 65 years, 87% presented with the ulcerative type, and 77% showed lower limb compromise. Read More

    [Pyoderma gangrenosum associated with anti-proteinase 3 antineutrophil cytoplasmic antibodies (PR3-ANCA) induced by propylthiouracil].
    Ann Dermatol Venereol 2017 Mar 10. Epub 2017 Mar 10.
    Département de dermatologie, grand hôpital de Charleroi (GHDC), Grand'Rue 3, 6000 Charleroi, Belgique.
    Background: Synthetic antithyroid drugs are often used in the treatment of hyperthyroidism, regardless of aetiology. They may cause various side effects, including the development of anti-neutrophil cytoplasmic antibodies (ANCA), ANCA-associated vasculitis, and neutrophilic dermatoses. Propylthiouracil (PTU) is the antithyroid drug most frequently implicated in ANCA-associated diseases specifically involving anti-myeloperoxidase ANCA (MPO-ANCA). Read More

    Pyoderma gangrenosum or necrotising fasciitis? Diagnostic and therapeutic wanderings.
    Orthop Traumatol Surg Res 2017 Mar 10. Epub 2017 Mar 10.
    Service d'orthopédie-traumatologie, hôpital universitaire de Limoges, 2, avenue Martin-Luther-King, 87000 Limoges, France.
    A case of post-traumatic lower-limb pyoderma gangrenosum (PG) in a 77-year-old female is reported. The diagnosis of PG is frequently one of exclusion, and it is therefore unsurprising that the condition was initially mistaken for necrotising fasciitis then for necrotising bacterial dermo-hypodermitis. Medical and surgical treatment for those conditions proved ineffective. Read More

    [First manifestation of leg ulcers : Analysis of data from 1000 patients].
    Hautarzt 2017 Mar 9. Epub 2017 Mar 9.
    Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland.
    Background: More than 1 million people in Germany suffer from leg ulcers. The diagnosis leg ulcer summarizes many different etiologies. The therapy of leg ulcers is an interdisciplinary and interprofessional challenge. Read More

    Oral Pyoderma Gangrenosum: Diagnosis, Treatment and Challenges: A Systematic Review.
    Head Neck Pathol 2017 Mar 8. Epub 2017 Mar 8.
    Oral and Maxillofacial Pathologist, Department of Stomatology, Faculty of Dentistry, Universite de Montreal, Montreal, QC, Canada.
    Pyoderma gangrenosum (PG) is a distinctive ulcerative skin disorder of unknown etiology, associated with an underlying systemic disease in up to 70% of cases. The condition is characterized by the appearance of one or more necrotic ulcers with a ragged undermined violaceous border and surrounding erythema. Lesions are often initiated by minor trauma. Read More

    Difficult and rare forms of acne.
    Clin Dermatol 2017 Mar - Apr;35(2):138-146. Epub 2016 Oct 27.
    Department of Dermatology, Andreas Syggros Hospital, University of Athens, 5, Dragoumi str, 16121, Athens, Greece.
    Acne is the most common of skin diseases, being characterized as a chronic inflammatory disease of the pilosebaceous unit. Although acne is usually straightforward to diagnose and treat, some patients have difficult or rare forms of acne. What seems to be "nonresponding acne" in a patient may be caused by another acneiform disease that clinically mimics acne, thus misleading the clinician, if not ruled out, with scrutiny. Read More

    Ecthyma gangrenosum in a 3-month-old, previously healthy infant: A Case Report.
    Medicine (Baltimore) 2017 Mar;96(10):e6244
    aDepartment of Dermatology bDepartment of Urology, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang cDepartment of Dermatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
    Rationale: Ecthyma gangrenosum (EG) is an aggressive cutaneous disease caused by local or systemic infection with Pseudomonas aeruginosa. EG is characterized by cutaneous manifestations ranging from nodule and papule, to necrotic ulceration with surrounding erythema, especially with black eschar or central crust. EG presents with characteristic skin lesions which is important to establish diagnosis of sepsis caused by P aeruginosa, a serious condition that can be treated efficiently if diagnosed early. Read More

    Pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome: differential diagnosis of septic arthritis by regular detection of exceedingly high synovial cell counts.
    Infection 2017 Mar 1. Epub 2017 Mar 1.
    Allgemeinmedizin und Sportmedizin Nymphenburg, Nymphenburger Str. 108a, 80636, Munich, Germany.
    Pyogenic arthritis, pyoderma gangrenosum and acne syndrome was diagnosed in a 42-year-old patient, after an unusual persistency of high synovial cell counts had been noticed. Clinical peculiarities and problems with diagnosing septic versus non-septic arthritis are discussed. Read More

    PAPA, PASH and PAPASH Syndromes: Pathophysiology, Presentation and Treatment.
    Am J Clin Dermatol 2017 Feb 25. Epub 2017 Feb 25.
    Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
    Pyoderma gangrenosum (PG) is a neutrophilic dermatosis usually manifesting as skin ulcers with undermined erythematous-violaceous borders. It may be isolated, associated with systemic conditions or occurring in the context of autoinflammatory syndromes such as PAPA (pyogenic arthritis, PG and acne), PASH (PG, acne and suppurative hidradenitis) or PAPASH (pyogenic arthritis, acne, PG and suppurative hidradenitis). From a physiopathological point of view, all these conditions share common mechanisms consisting of over-activation of the innate immune system leading to increased production of the interleukin (IL)-1 family and 'sterile' neutrophil-rich cutaneous inflammation. Read More

    Pediatric pyoderma gangrenosum: a systematic review and update.
    Int J Dermatol 2017 May 23;56(5):486-495. Epub 2017 Feb 23.
    Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
    Pyoderma gangrenosum (PG) is a sterile neutrophilic disorder that rarely affects children. Clinical, epidemiological, and therapeutic data on pediatric PG is poor as there are many newly reported associated diseases and drugs. This paper aims to review all recent available data on pediatric PG. Read More

    Exuberant pyoderma gangrenosum in a patient with autoimmune hepatitis.
    An Bras Dermatol 2017 Jan-Feb;92(1):114-117
    Department of Dermatology of the Universidade Federal do Rio de Janeiro (UFRJ) - Rio de Janeiro (RJ), Brazil.
    Pyoderma gangrenosum is a rare neutrophilic dermatosis, which usually presents as ulcers with erythematous-violaceous undermined edges and a rough base with purulent or sanguinous exudate. It can be primary or associated with an underlying disease. However, rare cases of its association with autoimmune hepatitis have been described in the literature. Read More

    Pyoderma Gangrenosum: An Update on Pathophysiology, Diagnosis and Treatment.
    Am J Clin Dermatol 2017 Feb 21. Epub 2017 Feb 21.
    Department of Dermatology, University of Miami Miller School of Medicine, Miami, FL, USA.
    Pyoderma gangrenosum (PG) is a rare inflammatory neutrophilic disorder with prototypical clinical presentations. Its pathophysiology is complex and not fully explained. Recent information regarding the genetic basis of PG and the role of auto-inflammation provides a better understanding of the disease and new therapeutic targets. Read More

    Pyoderma gangrenosum: A clinician's nightmare.
    J Family Med Prim Care 2016 Jul-Sep;5(3):698-700
    Department of Dermatology and Cosmetology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India.
    Pyoderma gangrenosum (PG) is a rare disease and that affecting specifically the sole of the foot, is even rarer. Here, we report the case of a 54-year-old female admitted with a painful ulcer on the sole of the right foot which was initially treated with empirical antibiotics and debridement. The disease was found to spread rapidly after each debridement. Read More

    Vasculitic and autoimmune wounds.
    J Vasc Surg Venous Lymphat Disord 2017 Mar 14;5(2):280-292. Epub 2016 Dec 14.
    Division of Rheumatology, The George Washington University, School of Medicine and Health Sciences, Washington, D.C.
    Objective: Chronic wounds are a major cause of morbidity and mortality. Approximately 20% to 23% of nonhealing wounds that are refractory to vascular intervention have other causes, including vasculitis, pyoderma gangrenosum, and other autoimmune diseases. The purpose of this article was to review the literature across medical and surgical specialties with regard to refractory chronic wounds associated with vasculitis and autoimmune diseases and to delineate clinical outcomes of these wounds in response to vascular and other interventions. Read More

    Pyoderma gangrenosum following autologous breast reconstruction.
    Gland Surg 2017 Feb;6(1):101-104
    Department of Plastic and Reconstructive Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
    Pyoderma gangrenosum (PG) is an uncommon disorder characterized by the development of painful cutaneous ulceration, commonly precipitated by dermal injury at surgical sites. It is a diagnostic challenge as it manifests as necrotizing wounds which are commonly misdiagnosed as postoperative wound infection or ischemia. We discuss the clinical features and histopathological findings that allow for rapid identification of PG following autologous breast reconstruction and suggest an algorithm to aid diagnosis. Read More

    Familial Mediterranean fever patients with hidradenitis suppurativa.
    Int J Dermatol 2017 Feb 14. Epub 2017 Feb 14.
    Department of Dermatology and Allergology, Ludwig-Maximilians University, Munich, Germany.
    Background: Hidradenitis suppurativa (HS) has recently been described as a component of two autoinflammatory syndromes: PASH (pyoderma gangrenosum, acne, and HS) and PAPASH (pyoderma gangrenosum, acne, pyogenic arthritis, and HS). These associations together with others such as inflammatory bowel diseases suggest that defects in autoinflammatory pathways may play a role in the pathogenesis of HS.

    Objectives: To describe clinical and genetic characteristics of two unrelated patients with HS and familial Mediterranean fever (FMF). Read More

    Pyoderma Gangrenosum of the breast: A case report study.
    Int J Surg Case Rep 2017 24;31:203-205. Epub 2017 Jan 24.
    Breast Unit, 1st Obstetrics and Gynecology Department, Athens University Medical School, Alexandra Hospital, Greece.
    Introduction: Pyoderma gangrenosum (PG) of the breast is a rare and rapidly spreading disease, which usually co-exists with severe underlying systemic conditions. PG often presents secondary to breast surgery with skin lesions and signs of infection, even though it is a non-infectious, necrotizing dermatological entity.

    Presentation Of Case: We present a case of de novo unilateral breast PG in 37-year-old woman, with a clear medical history whatsoever. Read More

    Osteitis in the Course of Pyodema Gangrenosum. Case Raport.
    Ortop Traumatol Rehabil 2016 Nov;18(6):611-619
    Department of Internal Medicine and Rheumatology, Medical University of Silesia, Katowice, Poland.
    We present the case of a male patient admitted to the Department of Orthopaedics and Musculoskeletal Traumatology, Medical University of Silesia (MUS) in Katowice, due to a right hindfoot abscess with calcaneal infiltration and pain in the forehead and the back, with evidence of local inflammation. The patient had a history of ulcerative colitis and sclerosing cholangitis was suspected. During the hospital stay, the patient underwent calcaneal CT, surgery (resection of an inflammatory focus) and MRI of the thoracic and lumbosacral spine, which revealed inflamed spinous processes of the Th10, Th11 and Th12 vertebrae. Read More

    Investigating the effect of independent, blinded digital image assessment on the STOP GAP trial.
    Trials 2017 Feb 2;18(1):53. Epub 2017 Feb 2.
    Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK.
    Background: Blinding is the process of keeping treatment assignment hidden and is used to minimise the possibility of bias. Trials at high risk of bias have been shown to report larger treatment effects than low-risk studies. In dermatology, one popular method of blinding is to have independent outcome assessors who are unaware of treatment allocation assessing the endpoint using digital photographs. Read More

    Treatment options for pyoderma gangrenosum.
    J Dtsch Dermatol Ges 2017 Jan;15(1):34-40
    Department of Dermatology and Venereology, Otto von Guericke University, Magdeburg, Germany.
    Pyoderma gangrenosum (PG) is an orphan disease. While research on such disorders is based on only few randomized multicenter as well as retrospective studies, most of the data comes from case series of small patient groups. Apart from topical and intralesional therapeutic options for early stages and mild disease courses, treatment predominantly involves systemic therapeutic agents. Read More

    Topical timolol for the treatment of pyoderma gangrenosum.
    BMJ Case Rep 2017 Jan 27;2017. Epub 2017 Jan 27.
    Centro Hospitalar São João, Porto, Portugal.
    Treatment of pyoderma gangrenosum (PG) remains a challenge, and there are currently no specific or uniformly effective therapies. Although widespread or rapidly progressive disease often requires systemic treatment, localised and mild lesions may be effectively controlled with topical agents. The most frequently applied topical drugs are corticosteroids and calcineurin inhibitors. Read More

    Monogenic Auto-inflammatory Syndromes: A Review of the Literature.
    Iran J Allergy Asthma Immunol 2016 Dec;15(6):430-444
    Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
    Auto-inflammatory syndromes are a new group of distinct hereditable disorders characterized by episodes of seemingly unprovoked inflammation (most commonly in skin, joints, gut, and eye), the absence of a high titer of auto-antibodies or auto-reactive T cells, and an inborn error of innate immunity. A narrative literature review was carried out of studies related to auto-inflammatory syndromes to discuss the pathogenesis and clinical manifestation of these syndromes. This review showed that the main monogenic auto-inflammatory syndromes are familial Mediterranean fever (FMF), mevalonate kinase deficiency (MKD), Blau syndrome, TNF receptor-associated periodic syndrome (TRAPS), cryopyrin-associated periodic syndrome (CAPS), and pyogenic arthritis with pyoderma gangrenosum and acne (PAPA). Read More

    Pyoderma Gangrenosum and Erythema Nodosum Revealing Takayasu's Arteritis.
    Case Rep Dermatol 2016 Sep-Dec;8(3):354-357. Epub 2016 Dec 7.
    University Hospital Basel, Basel, Switzerland; University of Basel, Basel, Switzerland.
    We report a Caucasian female who presented with simultaneous erythema nodosum and pyoderma gangrenosum due to underlying Takayasu's arteritis. Takayasu's arteritis is a chronic large vessel vasculitis of unknown cause. The disease has a worldwide distribution but is most commonly seen in Asian populations. Read More

    Pyoderma gangrenosum following complex reconstruction of a large-scale lower limb defect by combined Parascapular and latissimus dorsi flap.
    J Surg Case Rep 2017 Jan 17;2017(1). Epub 2017 Jan 17.
    Department of Hand, Plastic, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
    A female patient with a critical soft tissue defect after elective knee replacement surgery was transferred to our department for reconstruction. As wounds were rapidly progressing, necrotizing fasciitis was initially suspected but eventually ruled out by histopathological analysis. A 50 × 15 cm defect was then reconstructed by means of a combined Parascapular and latissimus dorsi flap before, a couple days later, the patient developed tender pustules and ulcers involving the flap as well as the donor site. Read More

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