Pyoderma gangrenosum
Pyoderma gangrenosum este o boală inflamatorie rară a pielii, în care pustulele sau nodulii dureroși evoluează în ulcere care cresc progresiv. Pyoderma gangrenosum nu este infecțioasă. Tratamentul poate include corticosteroizi, ciclosporină sau diverși anticorpi monoclonali. Deși poate afecta persoane de orice vârstă, este întâlnită mai frecvent la oamenii cu vârste cuprinse între 40 și 50 de ani.
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Pe piciorul unei persoane cu colită ulceroasă.
relevance score : -100.0%
ReferencesPyoderma gangrenosum este o afecțiune rară a pielii, caracterizată prin ulcere dureroase cu margini roșii sau violete. Este clasificată ca boală inflamatorie și face parte din grupul de dermatoze neutrofile. Etiologia pyoderma gangrenosum este complexă, implicând atât disfuncții ale imunității înnăscute, cât și ale celei adaptive, la persoanele cu predispoziție genetică. Recent, cercetătorii s-au concentrat pe foliculul de păr ca posibil punct de declanșare al bolii.
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 este o afecţiune rară a pielii care provoacă ulcere extrem de dureroase. Deși nu înţelegem pe deplin cauza acesteia, ştim că implică o activitate crescută a anumitor celule imune. Tratamentul bolii nu este încă uşor. Există diverse medicamente care suprimă sistemul imunitar sau îi modifică activitatea. Pe lângă acestea, ne concentrăm şi pe tratarea rănilor şi pe gestionarea durerii. Corticosteroizii şi ciclosporina sunt adesea prima alegere terapeutică, dar, în ultimul timp, au apărut numeroase studii privind utilizarea terapiilor biologice, cum ar fi inhibitorii de TNF‑α. Aceste medicamente biologice devin din ce în ce mai preferate, în special la pacienţii cu alte afecţiuni inflamatorii, şi sunt utilizate mai devreme în cursul bolii.
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.
