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In the beginning, Pyoderma gangraenosum shows itself through one or more elevations of the skin. In the course of time, blisters develop which become larger and larger. These blisters can also be filled with purulent fluid and are then called pustules.

At some point, the blisters disintegrate and ulcers remain. Often larger areas of skin are affected. During the healing process, extensive scars are formed. The skin now often shows a pigment disorder in this area. It is therefore possible that the scarred skin is darker or lighter than the original skin color.

Associated symptoms of Pyoderma gangraenosum

Unfortunately Pyoderma gangraenosum is described as a very painful disease. However, apart from the pain and the skin appearance itself, there are no other symptoms. Care should only be taken to protect the open skin as much as possible from bacterial colonization in order to avoid additional infection. If there are further physical symptoms, it is recommended to consult a physician who is familiar with autoimmune diseases, since Pyoderma gangraenosum often occurs in the context of these diseases. In this case, the accompanying symptoms could indicate the presence of an autoimmune disease such as ulcerative colitis or Crohn’s disease

Therapy of Pyoderma gangraenosum

For the therapy of Pyoderma gangraenosum, drugs from the group of immunosuppressive drugs are used. These are drugs that weaken the body’s immune system. They are useful here because the body keeps this disease going through its excessive inflammatory reaction.

First choice is cyclosporin A but other glucocorticoids can also be used. For local treatment, the open skin wound should first be protected from the penetration of germs with non-adhesive dressings. There are special wound dressings that promote granulation, which means that they support wound healing.

These dressings are also recommended for the clinical picture of Pyoderma gangraenosum. In addition, it can be helpful to refresh the wound edges again and again (i.e. to make targeted skin incisions at the wound edges again), which reignites the healing process.The application of a compression bandage is recommended for other conditions such as chronic venous insufficiency, which are also associated with leg ulcers. The aim here is to promote venous drainage, which is ultimately responsible for the development of the ulcers.

However, this is not the case with Pyoderma gangraenosum. Here, the causes lie in a misregulation of the immune system and the disease affects the arteries more than the veins. A compression bandage would probably aggravate the wound healing and is therefore not recommended.