Pyoderma gangrenosum: a review with special emphasis on Latin America literature

An Bras Dermatol. 2019 Nov-Dec;94(6):729-743. doi: 10.1016/j.abd.2019.06.001. Epub 2019 Nov 1.

Abstract

Pyoderma gangrenosum is a neutrophilic dermatosis characterized by chronic ulcers due to an abnormal immune response. Despite the existence of diagnostic criteria, there is no gold standard for diagnosis or treatment. In Latin America, recognizing and treating pyoderma gangrenosum is even more challenging since skin and soft tissue bacterial and non-bacterial infections are common mimickers. Therefore, this review aims to characterize reported cases of pyoderma gangrenosum in this region in order to assist in the assessment and management of this condition. Brazil, Mexico, Argentina, and Chile are the countries in Latin America that have reported the largest cohort of patients with this disease. The most frequent clinical presentation is the ulcerative form and the most frequently associated conditions are inflammatory bowel diseases, inflammatory arthropaties, and hematologic malignancies. The most common treatment modalities include systemic corticosteroids and cyclosporine. Other reported treatments are methotrexate, dapsone, and cyclophosphamide. Finally, the use of biological therapy is still limited in this region.

Keywords: Inflammatory bowel diseases; Latin America; Pyoderma gangrenosum; Skin ulcer.

Publication types

  • Systematic Review

MeSH terms

  • Diagnosis, Differential
  • Humans
  • Latin America / epidemiology
  • Prevalence
  • Pyoderma Gangrenosum / diagnosis*
  • Pyoderma Gangrenosum / epidemiology
  • Pyoderma Gangrenosum / pathology*
  • Pyoderma Gangrenosum / therapy