National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Pyoderma gangrenosum

Pyoderma gangrenosum is a rare, destructive inflammatory skin disease of which a painful nodule or pustule breaks down to form a progressively enlarging ulcer. Lesions may occur either in the absence of any apparent underlying disorder or in association with other diseases, such as ulcerative colitis, Crohn's disease, polyarthritis (an inflammation of several joints together), gammopathy, vasculitis, leukemia, and other conditions.[1][2][3] Each year in the United States, pyoderma gangrenosum occurs in about 1 person per 100,000 people.[1]

Pyoderma gangrenosum belongs to a group of autoinflammatory skin diseases called neutrophilic dermatoses.[2][3][4] Neutrophils are a type of white blood cell or leukocyte which form an early line of defense against bacterial infections.[5] Ulcerations associated with pyoderma gangrenosum may occur after trauma or injury to the skin, a process called pathergy.[1][2] Treatment involves wound care and the use of anti-inflammatory agents, including antibiotics, corticosteroids, immunosuppressants, and biologics.[1][2][3][4] 
Last updated: 8/15/2016

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

Showing of 15 |
Medical Terms Other Names
Learn More:
HPO ID
80%-99% of people have these symptoms
Arthralgia
Joint pain
0002829
Fever 0001945
Myalgia
Muscle ache
Muscle pain
[ more ] 		0003326
Myositis
Muscle inflammation
0100614
Papule 0200034
Skin ulcer
Open skin sore
0200042
30%-79% of people have these symptoms
Atrophic scars
Sunken or indented skin due to damage
0001075
Increased circulating antibody level 0010702
Inflammation of the large intestine 0002037
Myelodysplasia 0002863
Myeloid leukemia 0012324
Pustule
Pimple
0200039
Rheumatoid arthritis 0001370
5%-29% of people have these symptoms
Abnormal blistering of the skin
Blistering, generalized
Blisters
[ more ] 		0008066
Skin vesicle 0200037
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Last updated: 7/1/2020
Although antibiotics are often prescribed prior to having a correct diagnosis (and may be continued if there is a secondary infection or surrounding cellulitis), antibiotics are generally not helpful for treating uncomplicated cases of pyoderma gangrenosum.[3] The best documented treatments are systemic corticosteroids and cyclosporin A.[4] Smaller ulcers may be treated with strong topical steroid creams, steroid injections, special dressings, oral anti-inflammatory antibiotics, and/or other therapies. More severe cases typically require immunosuppressive therapy (used to decrease the body's immune responses). Combinations of steroids with cytotoxic drugs may be used in resistant cases. There has reportedly been rapid improvement of pyoderma gangrenosum with use of anti-tumor necrosis alpha therapy (such as infliximab), which is also used to treat Crohn's disease and other conditions.[2][3][4] Skin transplants and/or the application of bioengineered skin is useful in selected cases as a complementary therapy to immunosuppressive treatment.[4] The use of modern wound dressings is helpful to minimize pain and the risk of secondary infections.[3][4] Treatment for pyoderma gangrenosum generally does not involve surgery because it can result in enlargement of the ulcer; however, necrotic tissue (dying or dead tissue) should be gently removed.[3]

More detailed information about the treatment of pyoderma gangrenosum is available on the Treatment and Medication pages of Medscape Reference.
Last updated: 8/15/2016

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Pyoderma gangrenosum. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Patient Registry

  • The Autoimmune Registry supports research for Pyoderma gangrenosum by collecting information about patients with this and other autoimmune diseases. You can join the registry to share your information with researchers and receive updates about participating in new research studies. Learn more about registries.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Organizations Providing General Support

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • DermNet NZ is an online resource about skin diseases developed by the New Zealand Dermatological Society Incorporated. DermNet NZ provides information about this condition.
  • The Merck Manuals Online Medical Library provides information on this condition for patients and caregivers. 
  • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Pyoderma gangrenosum. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

  1. J Mark Jackson. Pyoderma Gangrenosum. Medscape Reference. April 26, 2016; http://emedicine.medscape.com/article/1123821-overview.
  2. Wingfield E. Rehmus. Pyoderma Gangrenosum. Merck Manual Professional Version. November 2013; http://www.merckmanuals.com/professional/dermatologic-disorders/hypersensitivity-and-inflammatory-disorders/pyoderma-gangrenosum?qt=Pyoderma%20gangrenosum&alt=sh.
  3. Amanda Oakley. Pyoderma gangrenosum. DermNet NZ. September 2015; http://www.dermnet.org.nz/reactions/pyoderma-gangrenosum.html.
  4. Uwe Wollina. Pyoderma gangrenosum. Orphanet. April 2007; http://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=EN&Expert=48104.
  5. Neil K. Kaneshiro. Neutrophils. MedlinePlus. November 19, 2015; https://medlineplus.gov/ency/imagepages/19864.htm.