Successful treatment of etanercept- and adalimumab-resistant pyoderma gangrenosum with spesolimab, moderate-dose corticosteroids, and minocycline. Pyoderma gangrenosum (PG) is a rare, neutrophilic dermatosis characterized by rapidly developing, painful ulcers. This study explores the potential of spesolimab, an anti-IL-36R antibody, as a therapeutic option for refractory PG. We report a case
Keratin variants in Pyoderma Gangrenosum: pathogenetic insights from a Whole Exome Sequencing-based bioinformatic analysis. Pyoderma gangrenosum (PG) is an inflammatory skin disorder belonging to the group of neutrophilic dermatoses. Clinically, it is typified by cutaneous ulcers with distinctive erythemato-violaceous borders and may occur alone or in association with other inflammatory
Pyoderma gangrenosum in a patient with multiple sclerosis under natalizumab treatment: a case report. Pyoderma Gangrenosum (PG) is often considered an immune-mediated disease. Up to 50% of PG cases - a rare, non-infectious inflammatory skin disease characterized by painful necrotic ulcers -are associated with underlying systemic diseases like Rheumatoid Arthritis (RA), and Inflammatory Bowel
Clinical Mimickers Misdiagnosed as Pyoderma Gangrenosum. Pyoderma gangrenosum (PG) is a rare, ulcerative, neutrophilic dermatosis that can be challenging to diagnose. Diagnosis of PG is clinical due to a lack of specific histopathologic, immunologic, or imaging findings associated with the disease, although several clinical frameworks exist to guide diagnosis. However, misdiagnosis of PG
Current prescribing for pyoderma gangrenosum in the UK and access to biologic medications: Results from a UK Dermatology Clinical Trials Network (UKDCTN) survey of UK Dermatologists. Pyoderma gangrenosum (PG) is an ulcerative inflammatory disorder affecting the lower legs in 80% of cases. The use of biologic medications to treat PG is increasing although there is a limited evidence base to guide
Deep Vein Thrombosis and Healing Outcomes in Patients With Pyoderma Gangrenosum. This single-center prospective case-control study assessed the association between deep vein thrombosis and healing outcomes in patients with pyoderma gangrenosum.
Interrupting an IFN-γ-dependent feedback loop in the syndrome of pyogenic arthritis with pyoderma gangrenosum and acne. To study the molecular pathogenesis of PAPA (pyogenic arthritis, pyoderma gangrenosum and acne) syndrome, a debilitating hereditary autoinflammatory disease caused by dominant mutation in . Gene knock-out and knock-in mice were generated to develop an animal model. THP1 serine dephosphorylation and was blocked by the p.W232A mutation, which disrupts pyrin-PSTPIP1 interaction. IFN-γ priming of monocytes from PAPA patients led to IL-18 release in a pyrin-dependent manner. IFN-γ was abundant in the inflamed dermis of PAPA patients, but not patients with idiopathic pyoderma gangrenosum. Ex vivo JAK inhibitor treatment attenuated IFN-γ-mediated pyrin induction and IL-18
Clinical, epidemiological, and therapeutic hallmarks of pyoderma gangrenosum: a case series of 35 patients. Over the past few decades, advances in medical research and diagnostic tools have shed light on some aspects of pyoderma gangrenosum (PG). Nevertheless, the multifactorial etiology, pathogenesis, and optimal management strategies for PG need to be further investigated. To address
Mortality and autopsy findings in patients with pyoderma gangrenosum: A multi-institutional series. Pyoderma gangrenosum (PG) is a rare ulcerative skin condition with an increased risk of mortality compared to the general population. The causes of this increased risk are not well understood. Misdiagnosis is common in pyoderma gangrenosum, and many studies are limited by the inclusion , and malignancy among those with PG is necessary for proper management. Further research is needed to explore the relationship between pyoderma gangrenosum and thromboembolism.
Doxycycline monotherapy for pyoderma vegetans: a case report. Pyoderma vegetans (PV) is a rare neutrophilic dermatosis of unknown etiology. Currently, there are no treatment guidelines for PV. Systemic steroids are often used as first-line therapy, but recurrence upon discontinuation or tapering is common. We tested the efficacy of doxycycline at a dose of 200 mg/d to treat resistant PV. After
Molecular methods enhance the detection of pyoderma-related Streptococcus pyogenes and emm-type distribution in children. Streptococcus pyogenes-related skin infections are increasingly implicated in the development of rheumatic heart disease (RHD) in lower-resourced settings, where they are often associated with scabies. The true prevalence of S. pyogenes-related pyoderma may be underestimated by bacterial culture. A multiplex qPCR for S. pyogenes, Staphylococcus aureus and Sarcoptes scabiei was applied to 250 pyoderma swabs from a cross-sectional study of children <5 years in The Gambia. Direct PCR-based emm-typing was used to supplement previous whole genome sequencing (WGS) of cultured isolates. Pyoderma lesions with S. pyogenes increased from 51% (127/250) using culture to 80% (199/250
Diagnostic and Therapeutic Challenges in Severe Peristomal Pyoderma Gangrenosum. In this case of a young female, ulcerations around the ileostoma appeared after colectomy and were thought to be due to surgical site infection. Given inadequate treatment, an extensive defect of the abdominal wall developed. Peristomal pyoderma gangrenosum was diagnosed, for which ustekinumab was given successfully.
Treatment of Pyoderma Gangrenosum With Vilobelimab. This case report describes a man in his 20s with psoriasis who was receiving stable treatment with adalimumab for 3 years and was diagnosed with pyoderma gangrenosum and was referred for a 6-month history of multiple inflammatory ulcers on the right dorsal foot and ankle.
Assessing the role of wound debridement in pyoderma gangrenosum-A retrospective cohort study. The role of wound debridement in pyoderma gangrenosum (PG) is controversial, largely due to concerns regarding pathergy. This study sought to evaluate the clinical outcomes and utility of wound debridement in PG management. We conducted a retrospective cohort study of 104 patients diagnosed with PG
The association between erythema nodosum and pyoderma gangrenosum and pediatric inflammatory bowel disease. The objectives of this study is to estimate rates and identify factors associated with erythema nodosum (EN) and pyoderma gangrenosum (PG) in pediatric patients with inflammatory bowel disease (IBD). This cohort study examined longitudinal visits of patients aged ≤ 21 years from
Insights into the Pathogenesis of Pyoderma Gangrenosum. Pyoderma gangrenosum (PG) is a neutrophilic dermatosis of unclear etiology. Numerous theories of its underlying pathogenesis have been proposed, including external triggers, neutrophilic dysfunction, complement activation, and autoimmunity, as well as a possible component of underlying genetic susceptibility. This review seeks to synthesize
Intravenous Immunoglobulin Therapy for Pyoderma Gangrenosum: A Multicenter Retrospective Analysis in 81 Patients. Pyoderma gangrenosum (PG) is rare neutrophil skin disease causing painful, progressively enlarging ulcers. Among the treatment options, intravenous immunoglobulin (IVIG) is a therapy of first choice for paraneoplastic PG. Otherwise, it is used in therapy-refractory courses. To assess
The Clinical and Molecular Response of Pyoderma Gangrenosum to Interleukin 23 Blockade: Result from a proof-of-concept open-label clinical trial. Pyoderma Gangrenosum is a severe ulcerative disease with a great need for novel therapies. A major barrier to the development of novel therapies is a lack of understanding of disease pathogenesis. We present the results of a proof-of-concept open label clinical trial of IL-23p19 antagonism with Tildrakizumab ion Pyoderma Gangrenosum. Gene expression analysis identified pro-inflammatory genes associated with interferon responses and dendritic cell activity including IFI27, XBP1, SAA1 LGALS3 and STAT3 significantly downregulated in lesional tissue after 12 weeks of therapy. Immunohistochemistry confirmed reduction in IL-17A and IL-17 F positive cells
Leishmaniasis masquerading as pyoderma gangrenosum in a non-endemic area: A case report. Pyoderma gangrenosum (PG) can be difficult to diagnose, leading to diagnostic delay which affects patient outcomes and increases health care utilization. Among different scenarios of diagnostic delay, atypical infections can mimic PG. Here, we present a case of extensive cutaneous leishmaniasis initially
Living with Pyoderma Gangrenosum: A Qualitative Study. Pyoderma gangrenosum is a rare, autoinflammatory disorder characterized by rapidly progressive painful ulcers that are challenging to diagnose and treat. This qualitative study aimed to explore the experiences of patients living with pyoderma gangrenosum. Using an inductive qualitative approach, semi-structured interviews were completed with a purposive sample of 21 patients with pyoderma gangrenosum recruited from a public dermatology outpatient clinic in Melbourne, Australia. A reflexive thematic analysis was performed, yielding 5 themes: pain, physical challenges, social functioning and relationships, mental health, and treatment. The impact of pyoderma gangrenosum on quality of life was multifaceted and varied throughout disease progression