Pyoderma gangrenosum
Pyoderma gangrenosum ialah penyakit kulit radang yang jarang berlaku, di mana pustula atau nodul yang menyakitkan berkembang menjadi ulser secara beransur-ansur. Pyoderma gangrenosum tidak berjangkit. Rawatan mungkin melibatkan kortikosteroid, cyclosporin, atau pelbagai antibodi monoklonal. Walaupun ia boleh menjejaskan individu pada mana-mana peringkat umur, kebanyakannya muncul pada orang berumur 40‑an hingga 50‑an.
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Kaki seseorang yang menghidap kolitis ulseratif.
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ReferencesPyoderma gangrenosum ialah keadaan kulit yang jarang berlaku dan menyebabkan ulser yang menyakitkan dengan tepi berwarna merah atau keunguan. Ia diklasifikasikan sebagai penyakit radang serta merupakan sebahagian daripada kumpulan yang dipanggil dermatosis neutrophilic. Punca Pyoderma gangrenosum adalah kompleks; ia melibatkan gangguan pada sistem imun semula jadi dan adaptif pada individu yang mempunyai predisposisi genetik. Baru-baru ini, para penyelidik telah menumpukan perhatian kepada folikel rambut sebagai titik permulaan yang berpotensi bagi penyakit ini.
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 adalah keadaan kulit yang jarang berlaku dan menyebabkan ulser yang sangat menyakitkan. Walaupun puncanya belum difahami sepenuhnya, kami tahu ia melibatkan peningkatan aktiviti sel imun tertentu. Rawatan penyakit ini masih mencabar. Kami mempunyai pelbagai ubat yang menekan atau mengubah suai sistem imun. Selain itu, kami juga memberi tumpuan kepada penjagaan luka dan pengurusan kesakitan. Kortikosteroid dan siklosporin biasanya menjadi pilihan pertama, tetapi kebelakangan ini terdapat lebih banyak kajian mengenai penggunaan terapi biologi seperti perencat TNF‑α. Biologik ini semakin diutamakan, terutamanya pada pesakit dengan keadaan keradangan lain, dan ia digunakan lebih awal dalam perjalanan penyakit.
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.
