{"id":2110,"date":"2019-10-21T15:37:31","date_gmt":"2019-10-21T15:37:31","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=2255"},"modified":"2026-02-02T20:22:18","modified_gmt":"2026-02-02T20:22:18","slug":"pyoderma-gangrenosum","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/pyoderma-gangrenosum\/","title":{"rendered":"Diagnostic Criteria of Ulcerative Pyoderma Gangrenosum (PG)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Pyoderma gangrenosum (PG) is a reactive non-infectious inflammatory dermatosis falling under the spectrum of the neutrophilic dermatoses, which includes Sweet\u2019s syndrome and Behcet\u2019s syndrome. <!--more--><\/p>\n<p><strong>Diagnostic tool for pyoderma gangrenosum<\/strong><\/p>\n<p><strong>Major criteria<\/strong><\/p>\n<ul>\n<li>Rapid progression of a painful necrolytic cutaneous ulcer with an irregular, violaceous and undermined border<\/li>\n<li>Other causes of cutaneous ulceration excluded<\/li>\n<\/ul>\n<p><strong>Minor criteria<\/strong><\/p>\n<ul>\n<li>History of pathergy or cribriform scarring clinically<\/li>\n<li>Associated systemic disease (inflammatory bowel disease, arthritis, IgA gammopathy or underlying malignancy)<\/li>\n<li>Classic histopathological findings<\/li>\n<li>Treatment response (rapid response to systemic steroid treatment \u2013 50% improvement in 1 month)<\/li>\n<\/ul>\n<p>The diagnostic tool requiring two major and two minor criteria, maintaining PG as a diagnosis of exclusion.<\/p>\n<p><strong>Improved diagnostic tool for pyoderma gangrenosum<\/strong><\/p>\n<p><strong>Major criterion<\/strong><\/p>\n<ul>\n<li>Biopsy of ulcer edge demonstrating neutrophilic infiltrate<\/li>\n<\/ul>\n<p><strong>Minor criteria<\/strong><\/p>\n<ul>\n<li>Exclusion of infection<\/li>\n<li>Pathergy<\/li>\n<li>History of inflammatory bowel disease or inflammatory arthritis<\/li>\n<li>History of papule, pustule or vesicle ulcerating within 4 days of appearing<\/li>\n<li>Peripheral erythema, undermining border, and tenderness at ulceration site<\/li>\n<li>Multiple ulcerations, at least one on anterior lower leg<\/li>\n<li>Cribriform or \u2018wrinkled paper\u2019 scar(s) at healed ulcer sites<\/li>\n<li>Decreased ulcer size within 1 month of initiating immunosuppressive medication(s)<\/li>\n<\/ul>\n<p>These new criteria are based on a consensus of international experts, which require a larger and four minor criteria.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Maverakis E, Ma C, Shinkai K, Fiorentino D, Callen JP, Wollina U, Marzano AV, Wallach D, Kim K, Schadt C, Ormerod A, Fung MA, Steel A, Patel F, Qin R, Craig F, Williams HC, Powell F, Merleev A, Cheng MY. Diagnostic Criteria of Ulcerative Pyoderma Gangrenosum: A Delphi Consensus of International Experts.\u00a0JAMA Dermatol. 2018 Apr 1;154(4):461-466. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29450466\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>George C, Deroide F, Rustin M. Pyoderma gangrenosum &#8211; a guide to diagnosis and management.\u00a0Clin Med (Lond). 2019 May;19(3):224-228. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31092515\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Tan B, Chen M, Hu X, He J, Zhang L, Du S, Mou Y, Xiong X, Duan X. Pyoderma Gangrenosum with Biological Agents Therapy: A Systematic Review. Clin Cosmet Investig Dermatol. 2025 Dec 15;18:3413-3427. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/41425114\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Oct 15, 2019.<br \/>\nUp-date Feb 2, 2026.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[34],"tags":[16,14,37,38,36,35],"class_list":["post-2110","post","type-post","status-publish","format-standard","hentry","category-dermatology","tag-criteria","tag-diagnostic","tag-gangrenosum","tag-pg","tag-pyoderma","tag-ulcerative"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2110","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2110"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2110\/revisions"}],"predecessor-version":[{"id":10612,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2110\/revisions\/10612"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2110"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2110"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2110"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}