Commentary: Pyoderma Gangrenosum

Abstract

The original article by Brunsting et al,¹ established pyoderma gangrenosum as a distinct clinical entity characterized by chronic, recurring, destructive ulcerations of the skin in association with ulcerative colitis (four cases) or other debilitating disease, eg, empyema (one case). Although bacteria are not the cause, and gangrene almost never supervenes, the term pyoderma gangrenosum remains well entrenched in the medical literature. The clinical concept of pyoderma gangrenosum has broadened considerably because of the wide variety of systemic diseases with which it may be associated, but the diagnosis still depends principally on the medical history and the clinical examination of the patient. No specific histologic or laboratory features of this disease have been demonstrated. In fact, a diversity of associated disorders and laboratory abnormalities found in patients with pyoderma gangrenosum has done little as yet to elucidate its pathogenesis, and treatment remains empiric. The clinical, histologic, and immunologic aspects of