Hopp til hovedinnhold

Pyoderma gangrenosum

Sist revidert:
Sist revidert av:


Definisjon:
Er en sjelden men alvorlig ulcererende hudsykdom ofte forbundet med underliggende systemsykdom
Forekomst:
I USA rapporteres det om 1 nytt tilfelle per 100.000 per år
Symptomer:
Sykdommen kan manifestere seg på ulike måter, den første lesjonen beskrives av pasienten som en smertefull bittreaksjon
Funn:
Initialt en liten, rød papel eller pustel som blir til en større ulcererende lesjon
Diagnostikk:
Et bredt arsenal av tilleggsundersøkelser er nødvendige som blodprøver, biopsi, dyrkning, ev. bildeundersøkelser
Behandling:
Ingen enkeltstående, spesifikk behandling eksisterer og få kontrollerte behandlingsstudier er utført. Prednison er førstevalg
  1. Schadt C. Pyoderma gangrenosum: Pathogenesis, clinical features, and diagnosis. UpToDate, last updated Jul 23, 2020. UpToDate  
  2. Jackson JM. Pyoderma gangrenosum. Medscape, last updated Sep 05, 2018. emedicine.medscape.com  
  3. Burian EA, Karlsmark T, Fogh K, Bech R. Ugeskr Laeger. 2021;183(24):V12200949. PubMed  
  4. Alavi A, French LE, Davis MD et al. Pyoderma gangrenosum: an update on pathophysiology, diagnosis and treatment. Am J Clin Dermatol 2017;18:355-72. PubMed  
  5. George C, Deroide F, Rustin M. Pyoderma gangrenosum – a guide to diagnosis and management. Clin Med (Lond) 2019;19:224-8. PubMed  
  6. Ruocco E, Sangiuliano S, Gravina AG, et al. Pyoderma gangrenosum: an updated review. J Eur Acad Dermatol Venereol 2009; 23:1008. PubMed  
  7. Ahronowitz I, Harp J, Shinkai K. Etiology and management of pyoderma gangrenosum: a comprehensive review. Am J Clin Dermatol 2012; 13:191. PubMed  
  8. Ashchyan HJ, Butler DC, Nelson CA, et al. The Association of Age With Clinical Presentation and Comorbidities of Pyoderma Gangrenosum. JAMA Dermatol 2018; 154: 409-13. pmid:29450453 PubMed  
  9. Reichrath J, Bens G, Bonowitz A, Tilgen W. Treatment recommendations for pyoderma gangrenosum: an evidence-based review of the literature based on more than 350 patients. J Am Acad Dermatol 2005; 53: 273-83. PubMed  
  10. Schadt C. Pyoderma gangrenosum: Treatment and prognosis. UpToDate, last updated Aug 18, 2020. UpToDate  
  11. Ormerod AD, Thomas KS, Craig FE, et al. Comparison of the two most commonly used treatments for pyoderma gangrenosum: results of the STOP GAP randomised controlled trial. BMJ. 2015 Jun 12;350:h2958. doi: 10.1136/bmj.h2958.
  12. Thomas KS, Ormerod AD, Craig FE, et al. Clinical outcomes and response of patients applying topical therapy for pyoderma gangrenosum: A prospective cohort study. J Am Acad Dermatol 2016; 75:940. PubMed  
  13. Binus AM, Qureshi AA, Li VW, Winterfield LS. Pyoderma gangrenosum: a retrospective review of patient characteristics, comorbidities and therapy in 103 patients. Br J Dermatol 2011; 165:1244. PubMed  
  14. Turner RB, Emer JJ, Weill M, et al. Rapid resolution of pyoderma gangrenosum after treatment with intravenous cyclosporine. J Am Acad Dermatol 2010; 63:e72. PubMed  
  15. Brooklyn TN, Dunnill MG, Shetty A, et al. Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial. Gut 2006; 55:505. Gut  
  16. Brooklyn TN, Dunnill MG, Shetty A, Bowden JJ, Williams JD, Griffiths CE, et al. Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial. Gut 2006; 55: 505-9. Gut  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Morten Dalaker, avtalespesialist i hudsykdommer, Trondheim Hudlegesenter, Carl Johans gt 3, 7010 Trondheim