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Pyoderma gangrenosum

Sist oppdatert: 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
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  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  
  17. Lee S, Lee JY, Ju HJ, et al. Association of All-Cause and Cause-Specific Mortality Risks With Pyoderma Gangrenosum. JAMA Dermatol 2022. pmid:36542392 PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

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