Overview

Pyoderma gangrenosum (pie-o-DUR-muh gang-ruh-NO-sum) is a rare condition that causes large, painful sores (ulcers) to develop on your skin, most often on your legs.

The exact causes of pyoderma gangrenosum are unknown, but it appears to be a disorder of the immune system. People who have certain underlying conditions, such as inflammatory bowel disease or arthritis, are at higher risk of pyoderma gangrenosum.

Pyoderma gangrenosum ulcers can develop quickly. They usually clear up with treatment, but scarring and recurrences are common.

Symptoms

Pyoderma gangrenosum usually starts with a small, red bump on your skin, which may resemble a spider bite. Within days, this bump can develop into a large, painful open sore.

The ulcer usually appears on your legs, but may develop anywhere on your body. Sometimes it appears around surgical sites. If you have several ulcers, they may grow and merge into one larger ulcer.

When to see a doctor

Talk to your doctor if you develop a painful, rapidly growing skin wound.

Causes

The exact cause of pyoderma gangrenosum is unknown. The condition is not infectious or contagious. It's often associated with autoimmune diseases such as ulcerative colitis, Crohn's disease and arthritis. And it may have a genetic component.

If you have pyoderma gangrenosum, new skin trauma, such as a cut or puncture wound, may trigger new ulcers.

Risk factors

Certain factors may increase your risk of pyoderma gangrenosum, including:

  • Your age and sex. The condition can affect anyone at any age, though it's more common between 20 and 50 years of age.
  • Having inflammatory bowel disease. People with a digestive tract disease such as ulcerative colitis or Crohn's disease are at increased risk of pyoderma gangrenosum.
  • Having arthritis. People with rheumatoid arthritis are at increased risk of pyoderma gangrenosum.
  • Having a blood disorder. People with acute myelogenous leukemia, myelodysplasia or a myeloproliferative disorder are at increased risk of pyoderma gangrenosum.

Complications

Possible complications of pyoderma gangrenosum include infection, scarring, uncontrolled pain, depression and loss of mobility.

Prevention

You can't totally prevent pyoderma gangrenosum. If you have the condition, try to avoid injuring your skin. Injury or trauma to your skin, including from surgery, can provoke new ulcers to form. It may also help to control any underlying condition that may be causing the ulcers.

Pyoderma gangrenosum care at Mayo Clinic

Dec. 04, 2018
References
  1. AskMayoExpert. Pyoderma gangrenosum. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
  2. AskMayoExpert. Skin ulcers. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
  3. DeFilipps EM, et al. The genetics of pyoderma gangrenosum and implications for treatment: A systematic review. British Journal of Dermatology. 2015;172:1487.
  4. Okhovat JP, et al. JAMA Dermatology Patient Page: Pyoderma gangrenosum. JAMA Dermatology. 2014;150:1032.
  5. Stair-Buchmann ME, et al. Pyoderma gangrenosum: A difficult diagnosis best managed in a burn treatment center. Journal of Burn Care Research. 2015;36:3190.
  6. Cabalag MS, et al. Inpatient management of pyoderma gangrenosum: Treatments, outcomes and clinical implications. Annals of Plastic Surgery. 2015;74:354.
  7. Bolognia JL, et al., eds. Neutrophilic dermatoses. In: Dermatology. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2018. https://www.clinicalkey.com. Accessed Oct. 8, 2018.
  8. Tolkachjov SN, et al. Postoperative pyoderma gangrenosum (PG): The Mayo Clinic experience of 20 years from 1994 through 2014. Journal of the American Academy of Dermatology. 2015;73:615.
  9. Afifi L, et al. Diagnosis and management of periostomal pyoderma gangrenosum: A systematic review. Journal of the American Academy of Dermatology. 2018;78:1195.
  10. Dabade TS, et al. Diagnosis and treatment of the neutrophilic dermatoses (pyoderma gangrenosum, Sweet's syndrome). Dermatologic Therapy. 2011;24:273.
  11. Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 29, 2018.