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Review

Pyoderma gangrenosum: a review of pathogenesis and treatment

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Pages 225-233 | Received 02 Nov 2017, Accepted 05 Feb 2018, Published online: 13 Feb 2018

References

  • Moschella S, Mark DM, Bolognia J, et al. Neutrophilic Dermatoses. Dermatology. 2015;3(1):423–438.
  • Langan SM, Groves RW, Card TR, et al. Incidence, mortality, and disease associations of pyoderma gangrenosum in the united kingdom: a retrospective cohort study. J Invest Dermatol. 2012;132(9):2166–2170.
  • Patterson JW. The vasculopathic reaction pattern. Weedon’s Skin Pathology. 2016;4:219–279.
  • Wallach D, Vignon-Pennamen MD. From acute febrile neutrophilic dermatosis to neutrophilic disease: forty years of clinical research. J Am Acad Dermatol. 2006;55(6):1066–1071.
  • Adachi Y, Kindzelskii AL, Cookingham G, et al. Aberrant neutrophil trafficking and metabolic oscillations in severe pyoderma gangrenosum. J Invest Dermatol. 1998;111(2):259–268.
  • Shore RN. Pyoderma gangrenosum, defective neutrophil chemotaxis, and leukemia. Arch Dermatol. 1976;112(12):1792–1793.
  • Madkaikar M, Italia K, Gupta M, et al. Leukocyte adhesion deficiency-I with a novel intronic mutation presenting with pyoderma gangrenosum-like lesions. J Clin Immunol. 2015;35(4):431–434.
  • Braswell SF, Kostopoulos TC, Ortega-Loayza AG. Pathophysiology of pyoderma gangrenosum (PG): an updated review. J Am Acad Dermatol. 2015;73(4):691–698.
  • Marzano AV, Cugno M, Trevisan V, et al. Role of inflammatory cells, cytokines and matrix metalloproteinases in neutrophil-mediated skin diseases. Clin Exp Immunol. 2010;162(1):100.
  • Brooklyn TN, Williams AM, Dunnill MG, et al. T-cell repertoire in pyoderma gangrenosum: evidence for clonal expansions and trafficking. Br J Dermatol. 2007;157(5):960–966.
  • Caproni M, Antiga E, Volpi W, et al. The Treg/Th17 cell ratio is reduced in the skin lesions of patients with pyoderma gangrenosum. Br J Dermatol. 2015;173(1):275–278.
  • Marzano AV, Fanoni D, Antiga E, et al. Expression of cytokines, chemokines and other effector molecules in two prototypic autoinflammatory skin diseases, pyoderma gangrenosum and sweet’s syndrome. Clin Exp Immunol. 2014;178(1):48–56.
  • Marzano AV, Damiani G, Ceccherini I, et al. Autoinflammation in pyoderma gangrenosum and its syndromic form (pyoderma gangrenosum, acne and suppurative hidradenitis). Br J Dermatol. 2017;176(6):1588–1598.
  • Marzano AV, Borghi A, Meroni PL, et al. Pyoderma gangrenosum and its syndromic forms: evidence for a link with autoinflammation. Br J Dermatol. 2016;175(5):882–891.
  • Marzano AV, Borghi A, Wallach D, et al. A comprehensive review of neutrophilic diseases. Clin Rev Allergy Immunol. 2018 Feb;54(1):114–130.
  • Sönmez HE, Özen S. A clinical update on inflammasomopathies. Int Immunol. 2017;29(9):393–400.
  • Chokoeva AA, Cardoso JC, Wollina U, et al. Pyoderma gangrenosum – a novel approach? Wien Med Wochenschr. 2017;167(3):58–65.
  • Marzano AV, Trevisan V, Gattorno M, et al. Pyogenic arthritis, pyoderma gangrenosum, acne, and hidradenitis suppurativa (PAPASH): a new autoinflammatory syndrome associated with a novel mutation of the PSTPIP1 gene. JAMA Dermatol. 2013;149(6):762–764.
  • Marzano AV, Ceccherini I, Gattorno M, et al. Association of pyoderma gangrenosum, acne, and suppurative hidradenitis (PASH) shares genetic and cytokine profiles with other autoinflammatory diseases. Medicine. 2014;93(27):187.
  • Calderón-Castrat X, Bancalari-Díaz D, Román-Curto C, et al. PSTPIP1 gene mutation in a pyoderma gangrenosum, acne, and suppurative hidradenitis (PASH) syndrome. Br J Dermatol. 2016;175(1):194–198.
  • Oka M. Pyoderma Gangrenosum and Interleukin 8. Br J Dermatol. 2007;157(6):1279–1281.
  • Oka M, Berking C, Nesbit M, et al. Interleukin-8 overexpression is present in pyoderma gangrenosum ulcers and leads to ulcer formation in human skin xenografts. Lab Invest. 2000;80(4):595–604.
  • Ortega-Loayza AG, Nugent WH, Lucero OM, et al. Dysregulation of inflammatory gene expression in lesional and non-lesional skin of patients with pyoderma gangrenosum. Br J Dermatol. 2018 Jan;178(1):e35–e36.
  • Bc W, Patel ED, Ortega-Loayza AG. Drug-induced pyoderma gangrenosum: a model to understand the pathogenesis of pyoderma gangrenosum. Br J Dermatol. 2017;177(1):72–83.
  • Binus AM, Qureshi AA, Li VW, et al. Pyoderma gangrenosum: a retrospective review of patient characteristics, comorbidities and therapy in 103 patients. Br J Dermatol Dermatology. 2011;165(6):1244–1250.
  • Kechichian E, Haber R, Mourad N, et al. Pediatric pyoderma gangrenosum: a systematic review and update. Int J Dermatol. 2017;56(5):486–495.
  • Kim RH, Lewin J, Hale CS, et al. Vegetative pyoderma gangrenosum. Dermatol Online J. 2014;20(12).
  • Sakiyama M, Kobayashi T, Nagata Y, et al. Bullous pyoderma gangrenosum: a case report and review of the published work. J Dermatol. 2012;39(12):1010–1015.
  • Barbosa NS, Tolkachjov SN, El-Azhary RA, et al. Clinical features, causes, treatments, and outcomes of peristomal pyoderma gangrenosum (PPG) in 44 patients: the Mayo Clinic experience, 1996 through 2013. J Am Acad Dermatol. 2016;75(5):931–939.
  • Schoch JJ, Tolkachjov SN, Cappel JA, et al. Pediatric pyoderma gangrenosum: a retrospective review of clinical features, etiologic associations, and treatment. Pediatr Dermatol. 2017;34(1):39–45.
  • Weizman A, Huang B, Berel D, et al. Clinical, serologic, and genetic factors associated with pyoderma gangrenosum and erythema nodosum in inflammatory bowel disease patients. Inflamm Bowel Dis. 2014;20(3):525–533.
  • Wang JY, French LE, Shear NH, et al. Drug-Induced Pyoderma Gangrenosum: A Review. Am J Clin Dermatol. 2018 Feb;19(1):67–77.
  • Steele RB, Nugent WH, Braswell SF, et al. Pyoderma gangrenosum and pregnancy: an example of abnormal inflammation and challenging treatment. Br J Dermatol. 2016;174(1):77–87.
  • Xia FD, Liu K, Lockwood S, et al. Risk of developing pyoderma gangrenosum after procedures in patients with a known history of pyoderma gangrenosum - a retrospective analysis. J Am Acad Dermatol. 2018 Feb;78(2):310–314.e1.
  • Herberger K, Dissemond J, Hohaus K, et al. Treatment of pyoderma gangrenosum: retrospective multicentre analysis of 121 patients. Br J Dermatol. 2016;175(5):1070–1072.
  • Marzano AV, Trevisan V, Lazzari R, et al. Pyoderna gangrenosum: a study of 21 patients and proposal of a ‘clinicotherapeutic’ classification. J Derm Treat. 2011;22(5):254–260.
  • Marzano AV, Trevisan V, Lazzari R, et al. Topical tacrolimus for the treatment of localized, idiopathic, newly diagnosed pyoderma gangrenosum. J Derm Treat. 2010;21(3):140–143.
  • Lyon CC, Stapleton M, Smith AJ, et al. Topical tacrolimus in the management of peristomal pyoderma gangrenosum. J Dermatol Treat. 2001;12(1):13–17.
  • Thomas KS, Ormerod AD, Craig FE, et al. Clinical outcomes and response of patients applying topical therapy for pyoderma gangrenosum: A prospective cohort study. J Am Acad Dermatol. 2016;75(5):940–949.
  • Sanders CJ, Hulsmans RF. Successful treatment of pyoderma gangrenosum with topical 5-aminosalicylic acid. Cutis. 1993;51(4):262–264.
  • Tamir A, Landau M, Brenner S. Topical treatment with 1% sodium cromoglycate in pyoderma gangrenosum. Dermatology. 1996;192(3):252–254.
  • Tsele E, Yu RC, Chu AC. Pyoderma gangrenosum: response to topical nitrogen mustard. Clin Exp Dermatol. 1992;17(6):437–440.
  • Ahronowitz I, Harp J, Shinkai K. Etiology and management of pyoderma gangrenosum: a comprehensive review. Am J Clin Dermatol. 2012;13(3):191–211.
  • Ormerod AD, Mason JM, Thomas KS, et al. Comparison of the two most commonly used treatments for pyoderma gangrenosum: results of the STOP GAP randomized controlled trial. Br J Dermatol. 2017;350:h2958.
  • Craig FF, Thomas KS, Mitchell EJ, et al. UK dermatology clinical trials network’s STOP GAP trial (a multicenter trial of prednisolone versus ciclosporin for pyoderma gangrenosum): protocol for a randomized controlled trial. Trials. 2012;13:51.
  • Kaur MR, Lewis HM. Severe recalcitrant pyoderma gangrenosum treated with infliximab. Br J Dermatol. 2005;153(3):689–691.
  • Goldminz AM, Botto NC, Gottlieb AB. Severely recalcitrant pyoderma gangrenosum successfully treated with ustekinumab. J Am Acad Dermatol. 2012;67(5):237–238.
  • Benzaquen M, Monnier J, Beaussault Y, et al. Pyoderma gangrenosum arising during treatment of psoriasis with adalimumab: effectiveness of ustekinumab. Australas J Dermatol. 2017;58:e270-e271. Epub ahead of print.
  • Guenova E, Teske A, Fehrenbacher B, et al. Interleukin 23 expression in pyoderma gangrenosum and targeted therapy with ustekinumab. Arch Dermatol. 2011;147(10):1203–1205.
  • Laird ME, Tong LX, Lo Sicco KI, et al. Novel use of apremilast for adjunctive treatment of recalcitrant pyoderma gangrenosum. JAAD Case Rep. 2017;3(3):228–229.
  • Wollina U. Emerging treatments for pyoderma gangrenosum. Exp Opin Orphan Drugs. 2017;5(10):827–832.
  • Song H, Lahood N, Mostaghimi A. Intravenous immunoglobulin as adjunct therapy for refractory pyoderma gangrenosum: systematic review of cases and case series. Br J Dermatol. 2017. Epub ahead of print.
  • Cugno M, Borghi A, Marzano AV. PAPA, PASH and PAPASH syndromes: pathophysiology, presentation and treatment. Am J Clin Dermatol. 2017;18(4):555–562.
  • Landis ET, Taheri A, Jorizzo JL. Gulliver’s sign: A recognizable transition from inflammatory to healing stages of pyoderma gangrenosum. J Dermatolog Treat. 2015;26(2):171–172.

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