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afya
Pyoderma Gangrenosum
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> very painful ulcers mostly on lower legs, M=F over 50 neutrophilic dermatosis esp with IBD, RA, chronic active hepatitis, wegeners, myeloid blood dyscrasia often starts at site of injury as bump then develops ulcer, purple, undermined, painful may resolve, persist or enlarge Rx of underlying condition may resolve ulcer also topical steroid, dapsone, tacrolimus/ciclosporin etc ''Features'' typically lower limbs initial small red papule, then deep red necrotic ulcer with violaceous border may have systemic Sx - fever, myalgia ''Causes'' 50% idiopathic Inflammatory bowel - UC and Crohns RA SLE Myeloproliferative disorders - lymphoma, myeloid leukaemia monoclonal gammopathy (IgA) Primary biliary cirrhosis May occur in DM but rare and generally not included in DD ''Mx'' potentail for rapid progression - most advice oral steroid immunosuppression if difficult (ciclosporin, infliximab)
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