Pyoderma gangrenosum
Ang Pyoderma gangrenosum ay isang bihirang, nagpapasiklab na sakit sa balat kung saan ang masakit na pustules o nodules ay nagiging mga ulser na unti-unting lumalaki. Ang pyoderma gangrenosum ay hindi nakakahawa. Maaaring kabilang sa mga paggamot ang corticosteroids, cyclosporin, o iba't ibang monoclonal antibodies. Bagama't maaari itong makaapekto sa mga tao sa anumang edad, kadalasang nakakaapekto ito sa mga taong nasa kanilang 40s at 50s.
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Sa binti ng taong may ulcerative colitis.
References
Ang Pyoderma gangrenosum ay isang bihirang kondisyon ng balat na nagdudulot ng masakit na mga ulser na may pula o purplish na mga gilid. Ito ay inuri bilang isang nagpapaalab na sakit at bahagi ng isang pangkat na tinatawag na neutrophilic dermatoses. Ang sanhi ng pyoderma gangrenosum ay masalimuot, na kinasasangkutan ng mga problema sa parehong likas at adaptive immunity sa mga taong may genetically prone. Kamakailan lamang, ang mga mananaliksik ay nakatuon sa follicule ng buhok bilang isang potensyal na panimulang punto ng sakit.
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.
Ang Pyoderma gangrenosum ay isang bihirang kondisyon ng balat na nagdudulot ng labis na masakit na mga ulser. Bagama't hindi namin lubos na nauunawaan ang sanhi nito, alam naming nagsasangkot ito ng pagtaas ng aktibidad ng ilang mga immune cell. Ang paggamot sa sakit ay hindi pa rin madali. Mayroon kaming iba't ibang gamot na pumipigil sa immune system o nagbabago sa aktibidad nito. Kasabay ng mga ito, nakatuon din kami sa paggamot sa mga sugat at pamamahala ng sakit. Ang mga corticosteroid at cyclosporine ay kadalasang unang pagpipilian para sa paggamot, ngunit kamakailan lamang, nagkaroon ng mas maraming pananaliksik sa paggamit ng mga biologic na therapies tulad ng mga TNF-α inhibitors. Mas pinipili ang mga biologic na ito, lalo na sa mga pasyente na may iba pang mga nagpapaalab na kondisyon, at ginagamit ang mga ito nang mas maaga sa proseso ng sakit.
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.
