Derm: Pyoderma gangrenosum: Free MSRA Podcast

🩹 FREE MSRA PODCAST – Pyoderma Gangrenosum: Pattern Recognition, Exclusion & Immunosuppression🎯 Everything you need to revise PG for the MSRA. From clinical recognition to management pearls—get the exam gold fast.Key Learning Points🔍 Definition• Pyoderma gangrenosum (PG) is a rare, inflammatory, non-infectious skin disorder• Presents as a painful, rapidly progressing ulcer, most often with undermined, violaceous borders💡 Causes & Risk Factors• Unknown aetiology—thought to be immune system dysregulation• Pathergy: minor trauma can trigger or worsen lesions• 50% associated with underlying disease: • Inflammatory bowel disease (Crohn’s/UC) • Rheumatoid arthritis, SLE • Haematological malignancies (e.g. leukaemia, lymphoma)• More common in adults (peak >50y), slight female predilection🧬 Pathophysiology• Dysfunctional neutrophil response—immune “friendly fire” damages tissue• Pathergy: skin injury → ulcer forms or worsens🩺 Clinical Features• Rapidly enlarging, painful ulcer with undermined, violaceous or erythematous edges• Often starts as a pustule or nodule• Most common on lower legs, but can occur anywhere• May be associated with systemic symptoms (fever, malaise)📝 Memory Tip: PUBPainful Ulcer with Boggy Undermined BordersPG = PUB!💡 Variants• Classic (most common): rapidly progressive leg ulcers• Peristomal: around stoma sites (esp. in IBD)• Vegetative: superficial plaques, less aggressive• Bullous: blisters/erosions, linked to haematological disease• Pustular: multiple pustules, often with IBD flares🔬 Diagnosis• Clinical + exclusion of other causes (infection, vasculitis, malignancy)• Biopsy: rules out other conditions (not diagnostic for PG itself)• Bloods: FBC, ESR, CRP, rheumatology screen• Swabs/cultures to exclude infection💊 Management• Systemic immunosuppression: steroids are 1st line (oral prednisolone), cyclosporin, infliximab or other biologics for refractory cases• Topical steroids for mild cases• Wound care: essential, but avoid surgery or debridement during active inflammation (can worsen PG via pathergy)• Treat underlying disease (e.g. IBD, RA)• Multidisciplinary approach: dermatology, rheumatology/gastro, wound care nurses📈 Prognosis & Complications• Can heal with scarring; recurrence common• Complications: chronic wounds, superadded infection, scarring, rare extracutaneous neutrophilic disease• Prognosis tied to underlying disease and response to treatment📎 More MSRA Revision for Pyoderma Gangrenosum:📝 Revision Notes: https://www.passthemsra.com/topic/pyoderma-gangrenosum-revision-notes/💬 Flashcards: https://www.passthemsra.com/topic/pyoderma-gangrenosum-flashcards/🧠 Accordion Q&A: https://www.passthemsra.com/topic/pyoderma-gangrenosum-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/pyoderma-gangrenosum-rapid-quiz/🧪 Full Quiz: https://www.passthemsra.com/quizzes/pyoderma-gangrenosum/🎓 Dermatology Course: https://www.passthemsra.com/courses/dermatology-for-the-msra/🌐 For more free & premium revision resources:https://www.passthemsra.com#MSRA #PyodermaGangrenosum #MSRARevision #MSRAQuiz #DermatologyMSRA #Immunosuppression #PassTheMSRA #FreeMSRA #PUBMnemonic #WoundCare