Volume 38 Issue 6
Jun.  2022
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Yang L,Yang QW,Fu YJ.Research advances on the pathogenesis and diagnosis of pyoderma gangrenosum[J].Chin J Burns Wounds,2022,38(6):569-573.DOI: 10.3760/cma.j.cn501225-20220331-00117.
Citation: Yang L,Yang QW,Fu YJ.Research advances on the pathogenesis and diagnosis of pyoderma gangrenosum[J].Chin J Burns Wounds,2022,38(6):569-573.DOI: 10.3760/cma.j.cn501225-20220331-00117.

Research advances on the pathogenesis and diagnosis of pyoderma gangrenosum

doi: 10.3760/cma.j.cn501225-20220331-00117
Funds:

General Program of Natural Science Foundation of Shandong Province of China ZR2021MH338

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  • Corresponding author: Fu Yanjie, Email: zcfyjzzy@163.com
  • Received Date: 2022-03-31
  • Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis, closely associated with the immune system. Its pathogenesis is currently not clear. The lack of specificity in the clinical manifestations and histopathological changes of PG leads to a long clinical diagnosis cycle and even misdiagnosis, which is easy to delay treatment or promote the deterioration of ulcer wound. The diagnosis of this disease is still very difficult, which poses a great challenge to wound repair practitioners. This article reviews the research advances on the pathophysiology, clinical features, and diagnosis of PG in recent years, with the aim of providing reference for relevant clinical practitioners.

     

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  • [1]
    Smith-PliegoM,Contreras-RuizJ,RyanS,et al.Cutaneous malakoplakia masquerading as pyoderma gangrenosum[J].Int Wound J,2017,14(4):658-660.DOI: 10.1111/iwj.12661.
    [2]
    LanganSM,GrovesRW,CardTR,et al.Incidence, mortality, and disease associations of pyoderma gangrenosum in the United Kingdom: a retrospective cohort study[J].J Invest Dermatol,2012,132(9):2166-2170.DOI: 10.1038/jid.2012.130.
    [3]
    AlaviA,FrenchLE,DavisMD,et al.Pyoderma gangrenosum: an update on pathophysiology, diagnosis and treatment[J].Am J Clin Dermatol,2017,18(3):355-372.DOI: 10.1007/s40257-017-0251-7.
    [4]
    Greenlee-WackerMC.Clearance of apoptotic neutrophils and resolution of inflammation[J].Immunol Rev,2016,273(1):357-370.DOI: 10.1111/imr.12453.
    [5]
    SatohTK,MellettM,ContassotE,et al.Are neutrophilic dermatoses autoinflammatory disorders?[J].Br J Dermatol,2018,178(3):603-613.DOI: 10.1111/bjd.15105.
    [6]
    Vignon-PennamenMD,WallachD.Cutaneous manifestations of neutrophilic disease. A study of seven cases[J].Dermatologica,1991,183(4):255-264.DOI: 10.1159/000247696.
    [7]
    MistryP,Carmona-RiveraC,OmbrelloAK,et al.Dysregulated neutrophil responses and neutrophil extracellular trap formation and degradation in PAPA syndrome[J].Ann Rheum Dis,2018,77(12):1825-1833.DOI: 10.1136/annrheumdis-2018-213746.
    [8]
    WangY,LiM,StadlerS,et al.Histone hypercitrullination mediates chromatin decondensation and neutrophil extracellular trap formation[J].J Cell Biol,2009,184(2):205-213.DOI: 10.1083/jcb.200806072.
    [9]
    SørensenOE,BorregaardN.Neutrophil extracellular traps - the dark side of neutrophils[J].J Clin Invest,2016,126(5):1612-1620.DOI: 10.1172/JCI84538.
    [10]
    PapayannopoulosV.Neutrophil extracellular traps in immunity and disease[J].Nat Rev Immunol,2018,18(2):134-147.DOI: 10.1038/nri.2017.105.
    [11]
    AdachiY,KindzelskiiAL,CookinghamG,et al.Aberrant neutrophil trafficking and metabolic oscillations in severe pyoderma gangrenosum[J].J Invest Dermatol,1998,111(2):259-268.DOI: 10.1046/j.1523-1747.1998.00311.x.
    [12]
    McKenzieF,ArthurM,Ortega-LoayzaAG. Pyoderma gangrenosum: what do we know now?[J]. Current Dermatology Reports,2018,7(4):147-157.DOI: 10.1007/s13671-018-0224-y.
    [13]
    AntonelliE,BassottiG,TramontanaM,et al.Dermatological manifestations in inflammatory bowel diseases[J].J Clin Med,2021,10(2):364.DOI: 10.3390/jcm10020364.
    [14]
    CugnoM,BorghiA,MarzanoAV.PAPA, PASH and PAPASH syndromes: pathophysiology, presentation and treatment[J].Am J Clin Dermatol,2017,18(4):555-562.DOI: 10.1007/s40257-017-0265-1.
    [15]
    PlumptreI,KnabelD,TomeckiK.Pyoderma gangrenosum: a review for the gastroenterologist[J].Inflamm Bowel Dis,2018,24(12):2510-2517.DOI: 10.1093/ibd/izy174.
    [16]
    HobbsMM,Ortega-LoayzaAG.Pyoderma gangrenosum: from historical perspectives to emerging investigations[J].Int Wound J,2020,17(5):1255-1265.DOI: 10.1111/iwj.13389.
    [17]
    MaverakisE,MarzanoAV,LeST,et al.Pyoderma gangrenosum[J].Nat Rev Dis Primers,2020,6(1):81.DOI: 10.1038/s41572-020-0213-x.
    [18]
    WangEA,SteelA,LuxardiG,et al.Classic ulcerative pyoderma gangrenosum is a T cell-mediated disease targeting follicular adnexal structures: a hypothesis based on molecular and clinicopathologic studies[J].Front Immunol,2018,8:1980.DOI: 10.3389/fimmu.2017.01980.
    [19]
    CaproniM,AntigaE,VolpiW,et al.The Treg/Th17 cell ratio is reduced in the skin lesions of patients with pyoderma gangrenosum[J].Br J Dermatol,2015,173(1):275-278.DOI: 10.1111/bjd.13670.
    [20]
    QuaglinoP,FavaP,CaproniM,et al.Phenotypical characterization of circulating cell subsets in pyoderma gangrenosum patients: the experience of the Italian immuno-pathology group[J].J Eur Acad Dermatol Venereol,2016,30(4):655-658.DOI: 10.1111/jdv.13100.
    [21]
    NesterovitchAB,GyorfyZ,HoffmanMD,et al.Alteration in the gene encoding protein tyrosine phosphatase nonreceptor type 6 (PTPN6/SHP1) may contribute to neutrophilic dermatoses[J].Am J Pathol,2011,178(4):1434-1441.DOI: 10.1016/j.ajpath.2010.12.035.
    [22]
    NesterovitchAB,SzantoS,GondaA,et al.Spontaneous insertion of a b2 element in the Ptpn6 gene drives a systemic autoinflammatory disease in mice resembling neutrophilic dermatosis in humans[J].Am J Pathol,2011,178(4):1701-1714.DOI: 10.1016/j.ajpath.2010.12.053.
    [23]
    NesterovitchAB,ArbievaZ,TothDM,et al.A differential gene expression study: Ptpn6 (SHP-1)-insufficiency leads to neutrophilic dermatosis-like disease (NDLD) in mice[J].J Dermatol Sci,2016,83(1):17-25.DOI: 10.1016/j.jdermsci.2016.03.005.
    [24]
    SoodAK,McShaneDB,GoogePB,et al.Successful treatment of PAPA syndrome with dual adalimumab and tacrolimus therapy[J].J Clin Immunol,2019,39(8):832-835.DOI: 10.1007/s10875-019-00685-6.
    [25]
    WangY,WuN,YuK,et al.Case report: pyogenic arthritis, pyoderma gangrenosum, and acne: a single-center experience and literature review[J].Front Immunol,2021,12:735851.DOI: 10.3389/fimmu.2021.735851.
    [26]
    MaitrepierreF,MarzanoAV,LipskerD.A unified concept of acne in the PAPA spectrum disorders[J].Dermatology,2021,237(5):827-834.DOI: 10.1159/000509874.
    [27]
    AhnC,NegusD,HuangW.Pyoderma gangrenosum: a review of pathogenesis and treatment[J].Expert Rev Clin Immunol,2018,14(3):225-233.DOI: 10.1080/1744666X.2018.1438269.
    [28]
    Alonso-LeónT,Hernández-RamírezHH,Fonte-AvalosV,et al.The great imitator with no diagnostic test: pyoderma gangrenosum[J].Int Wound J,2020,17(6):1774-1782.DOI: 10.1111/iwj.13466.
    [29]
    GeorgeC,DeroideF,RustinM.Pyoderma gangrenosum - a guide to diagnosis and management[J].Clin Med (Lond),2019,19(3):224-228.DOI: 10.7861/clinmedicine.19-3-224.
    [30]
    SullivanSN.Bullous pyoderma gangrenosum and inflammatory bowel disease[J].Inflamm Bowel Dis,2018,24(5):e16-e17.DOI: 10.1093/ibd/izy018.
    [31]
    ShavitE,CecchiniM,LimacherJJ,et al.Superficial granulomatous pyoderma gangrenosum involving the face: a case series of five patients and a review of the literature [formula: see text][J].J Cutan Med Surg,2021,25(4):371-376.DOI: 10.1177/1203475420988864.
    [32]
    AfifiL,SanchezIM,WallaceMM,et al.Diagnosis and management of peristomal pyoderma gangrenosum: a systematic review[J].J Am Acad Dermatol,2018,78(6):1195-1204.e1.DOI: 10.1016/j.jaad.2017.12.049.
    [33]
    PearsonWA,PrenticeDA,SinclairDL,et al.A novel topical therapy for resistant and early peristomal pyoderma gangrenosum[J].Int Wound J,2019,16(5):1136-1143.DOI: 10.1111/iwj.13164.
    [34]
    XuA,BalgobindA,StrunkA,et al.Prevalence estimates for pyoderma gangrenosum in the United States: an age- and sex-adjusted population analysis[J].J Am Acad Dermatol,2020,83(2):425-429.DOI: 10.1016/j.jaad.2019.08.001.
    [35]
    GuptaAS,Ortega-LoayzaAG.Ocular pyoderma gangrenosum: a systematic review[J].J Am Acad Dermatol,2017,76(3):512-518.DOI: 10.1016/j.jaad.2016.08.049.
    [36]
    ScherlingerM,GuilletS,DoutreMS,et al.Pyoderma gangrenosum with extensive pulmonary involvement[J].J Eur Acad Dermatol Venereol,2017,31(4):e214-e216.DOI: 10.1111/jdv.13976.
    [37]
    KridinK,CohenAD,AmberKT.Underlying systemic diseases in pyoderma gangrenosum: a systematic review and meta-analysis[J].Am J Clin Dermatol,2018,19(4):479-487.DOI: 10.1007/s40257-018-0356-7.
    [38]
    WallachD,Vignon-PennamenMD.Pyoderma gangrenosum and Sweet syndrome: the prototypic neutrophilic dermatoses[J].Br J Dermatol,2018,178(3):595-602.DOI: 10.1111/bjd.13955.
    [39]
    FloraA,KozeraE,FrewJW.Pyoderma gangrenosum: a systematic review of the molecular characteristics of disease[J].Exp Dermatol,2022,31(4):498-515.DOI: 10.1111/exd.14534.
    [40]
    MarzanoAV,BorghiA,WallachD,et al.A comprehensive review of neutrophilic diseases[J].Clin Rev Allergy Immunol,2018,54(1):114-130.DOI: 10.1007/s12016-017-8621-8.
    [41]
    LandisET,TaheriA,JorizzoJL.Gulliver's sign: a recognizable transition from inflammatory to healing stages of pyoderma gangrenosum[J].J Dermatolog Treat,2015,26(2):171-172.DOI: 10.3109/09546634.2014.883061.
    [42]
    SkopisM,ElghawyAA,PociurkoB,et al.Pyoderma gangrenosum associated with limited cutaneous systemic sclerosis: a rare case with literature review[J].Clin Rheumatol,2021,40(3):1141-1145.DOI: 10.1007/s10067-020-05285-z.
    [43]
    JockenhöferF,WollinaU,SalvaKA,et al.The PARACELSUS score: a novel diagnostic tool for pyoderma gangrenosum[J].Br J Dermatol,2019,180(3):615-620.DOI: 10.1111/bjd.16401.
    [44]
    MaverakisE,MaC,ShinkaiK,et al.Diagnostic criteria of ulcerative pyoderma gangrenosum: a Delphi consensus of international experts[J].JAMA Dermatol,2018,154(4):461-466.DOI: 10.1001/jamadermatol.2017.5980.
    [45]
    GoldustM,HagstromEL,RathodD,et al.Diagnosis and novel clinical treatment strategies for pyoderma gangrenosum[J].Expert Rev Clin Pharmacol,2020,13(2):157-161.DOI: 10.1080/17512433.2020.1709825.
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