Management of pyoderma gangrenosum.
Pyoderma gangrenosum (PG) is an uncommon ulcerative skin disease often associated with underlying systemic diseases. Its pathogenesis is unknown, although immune pathways have been implicated. Targeted therapy is therefore lacking and currently treatment is largely empirical and consists of corticos...
| Publicado en: | Journal of the Royal Society of Medicine Vol. 107; no. 6; pp. 228 - 237 |
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| Autores principales: | , |
| Formato: | Journal Article |
| Publicado: |
Sage Publications Inc.
Jun2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=97424958&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 97424958 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01410768 1G2 jtl: Journal of the Royal Society of Medicine issn: 01410768 maglogo: Y pubinfo: dt: Jun2014 vid: 107 iid: 6 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 97424958 97424958 NLM24912791 10.1177/0141076814534407 NLM24912791 97424958 ppf: 228 ppct: 9 formats: tig: atl: Management of pyoderma gangrenosum. aug: au: Teagle, Alexandra Hargest, Rachel affil: Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton BN2 5BE, UK, Department of Surgery, Cardiff University School of Medicine, UHW Main Building, Heath Park, Cardiff CF14 4XN, UK sug: ab: Pyoderma gangrenosum (PG) is an uncommon ulcerative skin disease often associated with underlying systemic diseases. Its pathogenesis is unknown, although immune pathways have been implicated. Targeted therapy is therefore lacking and currently treatment is largely empirical and consists of corticosteroids and ciclosporin first line. This paper reviews the current and emerging knowledge about PG. PG occurs with an incidence of 3–10 per million per year. The ulcers are exquisitely painful and characteristically have a necrotic centre with irregular overhanging bluish borders. Around half of cases are associated with underlying systemic disease, most commonly inflammatory bowel disease, rheumatoid arthritis and haematological malignancies; the remaining cases are idiopathic. The pathogenesis is unknown, but the most widely supported theory is immunological, and biopsies of lesions show a predominantly neutrophilic infiltrate. Several aberrant immune processes have been described, with neutrophils and their recruitment to sites of inflammation by cytokines taking an apparently important role. Topical and systemic therapies are both vital aspects of treatment, and in recent years, immune modulators have been used with increasing success, with an emerging role for anti-tumour necrosis factor alpha agents such as the monoclonal antibody infliximab. Although uncommon, PG causes significant morbidity to those it affects. Further research is needed into the disease pathogenesis, and adequate targeted treatment. pubtype: Academic Journal doctype: Journal Article ougenre: Unknown language: English refInfo: holdings: @attributes: islocal: N |
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