Pyoderma gangrenosum
Pyoderma gangrenosum er en sjælden, inflammatorisk hudsygdom, hvor smertefulde pustler eller knuder bliver til sår, der gradvist vokser. Pyoderma gangrenosum er ikke infektiøs. Behandlinger kan omfatte kortikosteroider, ciclosporin eller forskellige monoklonale antistoffer. Selvom det kan påvirke mennesker i alle aldre, rammer det for det meste mennesker i 40'erne og 50'erne.
☆ I 2022 Stiftung Warentest-resultaterne fra Tyskland var forbrugernes tilfredshed med ModelDerm kun lidt lavere end med betalte telemedicinske konsultationer.
På benet af en person med colitis ulcerosa.
References
Pyoderma gangrenosum er en sjælden hudsygdom, der forårsager smertefulde sår med røde eller lilla kanter. Det er klassificeret som en inflammatorisk sygdom og er en del af en gruppe kaldet neutrofile dermatoser. Årsagen til pyoderma gangrenosum er kompleks og involverer problemer med både medfødt og adaptiv immunitet hos mennesker, der er genetisk tilbøjelige. For nylig har forskere fokuseret på hårsækken som et potentielt udgangspunkt for sygdommen.
Pyoderma gangrenosum is a rare inflammatory skin disease classified within the group of neutrophilic dermatoses and clinically characterized by painful, rapidly evolving cutaneous ulcers with undermined, irregular, erythematous-violaceous edges. Pyoderma gangrenosum pathogenesis is complex and involves a profound dysregulation of components of both innate and adaptive immunity in genetically predisposed individuals, with the follicular unit increasingly recognized as the putative initial target.
Pyoderma gangrenosum is a rare inflammatory skin disease classified within the group of neutrophilic dermatoses and clinically characterized by painful, rapidly evolving cutaneous ulcers with undermined, irregular, erythematous-violaceous edges. Pyoderma gangrenosum pathogenesis is complex and involves a profound dysregulation of components of both innate and adaptive immunity in genetically predisposed individuals, with the follicular unit increasingly recognized as the putative initial target.
Pyoderma gangrenosum er en sjælden hudlidelse, der forårsager ekstremt smertefulde sår. Selvom vi ikke helt forstår dens årsag, ved vi, at det involverer øget aktivitet af visse immunceller. Det er stadig ikke let at behandle sygdommen. Vi har forskellige lægemidler, der undertrykker immunsystemet eller modificerer dets aktivitet. Sideløbende med disse har vi også fokus på behandling af sår og smertehåndtering. Kortikosteroider og cyclosporin er ofte det første valg til behandling, men på det seneste er der blevet forsket mere i brugen af biologiske terapier som TNF-α-hæmmere. Disse biologiske lægemidler foretrækkes i stigende grad, især hos patienter med andre inflammatoriske tilstande, og de bliver brugt tidligere i sygdomsprocessen.
Pyoderma gangrenosum is a rare neutrophilic dermatosis that leads to exceedingly painful ulcerations of the skin. Although the exact pathogenesis is not yet fully understood, various auto-inflammatory phenomena with increased neutrophil granulocyte activity have been demonstrated. Despite the limited understanding of the pathogenesis, it is no longer a diagnosis of exclusion, as it can now be made on the basis of validated scoring systems. However, therapy remains a major multidisciplinary challenge. Various immunosuppressive and immunomodulatory therapies are available for the treatment of affected patients. In addition, concomitant topical pharmacologic therapy, wound management and pain control should always be addressed. Corticosteroids and/or cyclosporine remain the systemic therapeutics of choice for most patients. However, in recent years, there has been an increasing number of studies on the positive effects of biologic therapies such as inhibitors of tumour necrosis factor-α; interleukin-1, interleukin-17, interleukin-23 or complement factor C5a. Biologics have now become the drug of choice in certain scenarios, particularly in patients with underlying inflammatory comorbidities, and are increasingly used at an early stage in the disease rather than in therapy refractory patients.
Pyoderma gangrenosum is a rare neutrophilic dermatosis that leads to exceedingly painful ulcerations of the skin. Although the exact pathogenesis is not yet fully understood, various auto-inflammatory phenomena with increased neutrophil granulocyte activity have been demonstrated. Despite the limited understanding of the pathogenesis, it is no longer a diagnosis of exclusion, as it can now be made on the basis of validated scoring systems. However, therapy remains a major multidisciplinary challenge. Various immunosuppressive and immunomodulatory therapies are available for the treatment of affected patients. In addition, concomitant topical pharmacologic therapy, wound management and pain control should always be addressed. Corticosteroids and/or cyclosporine remain the systemic therapeutics of choice for most patients. However, in recent years, there has been an increasing number of studies on the positive effects of biologic therapies such as inhibitors of tumour necrosis factor-α; interleukin-1, interleukin-17, interleukin-23 or complement factor C5a. Biologics have now become the drug of choice in certain scenarios, particularly in patients with underlying inflammatory comorbidities, and are increasingly used at an early stage in the disease rather than in therapy refractory patients.
