Division of Dermatology, University of Ottawa, 737 Parkdale Avenue, 4th Floor Dermatology, Ottawa, ON K1Y1J8, Canada.
Mohs Micrographic & Reconstructive Surgery, Epiphany Dermatology, Department of Dermatology, Baylor University Medical Center, University of Texas at Southwestern, Texas A&M University School of Medicine, 1640 FM 544, Suite 100, Lewisville, TX 75056, USA.
Dermatol Clin. 2024 Apr;42(2):183-192. doi: 10.1016/j.det.2023.12.002. Epub 2023 Dec 29.
Pyoderma gangrenosum is a rare neutrophilic dermatosis that results in painful cutaneous ulcers and is frequently associated with underlying hematologic disorders, inflammatory bowel disease, or other autoimmune disorders. Pathogenesis involves an imbalance between proinflammatory and anti-inflammatory mediators, leading to tissue damage from neutrophils. First-line treatment options with the greatest evidence include systemic corticosteroids, cyclosporine, and tumor necrosis factor alpha inhibitors. Other steroid-sparing therapies such as dapsone, mycophenolate mofetil, intravenous immunoglobulin, and targeted biologic or small molecule inhibitors also have evidence supporting their use. Wound care and management of underlying associated disorders are critical parts of the treatment regimen.
坏疽性脓皮病是一种罕见的中性粒细胞皮肤病，可导致疼痛性皮肤溃疡，常与潜在的血液系统疾病、炎症性肠病或其他自身免疫性疾病有关。发病机制涉及促炎和抗炎介质之间的失衡，导致中性粒细胞引起的组织损伤。具有最大证据的一线治疗选择包括全身皮质类固醇、环孢素和肿瘤坏死因子α抑制剂。其他类固醇节约疗法，如氨苯砜、霉酚酸酯、静脉注射免疫球蛋白和靶向生物制剂或小分子抑制剂，也有证据支持其使用。伤口护理和潜在相关疾病的管理是治疗方案的关键部分。
