A. Acute febrile neutrophilic dermatosis
B. Wegener Granulomatosis
C. Pyoderma Gangrenosum
D. Tuberculosis gumma
Ans:C. Pyoderma Gangrenosum.
- It is a rare, neutrophilic dermatosis, commonly associated with systemic disease. The typical presentation is a painful ulcer (or ulcers) that grows rapidly and develops an irregular, undermined, purple edge..Pyoderma gangrenosum ulcers demonstrate pathergy, that is, a worsening in response to minor trauma or surgical debridement.
Inflammatory bowel disease:
- Ulcerative colitis
- Crohn’s disease
- Rheumatoid arthritis
- Seronegative arthritis
- Myelocytic leukemia
- Hairy cell leukemia
- Myeloid metaplasia
- Monoclonal gammopathy
- Pyogenic sterile arthritis, pyoderma gangrenosum, and acne syndrome (PAPA syndrome)
- Granulomatosis with polyangiitis
- Often a diagnosis of exclusion, skin biopsy shows a massive neutrophilic infiltration, hemorrhage, and necrosis of the overlying epidermis.
- First-line therapy for disseminated or localized instances of pyoderma gangrenosum is systemic treatment by corticosteroids and ciclosporin. Topical application of clobetasol, mupirocin, and gentamicin alternated with tacrolimus can be effective.
- If ineffective, alternative therapeutic procedures include systemic treatment with corticosteroids and mycophenolate mofetil; mycophenolate mofetil and ciclosporin; tacrolimus; thalidomide; infliximab; or plasmapheresis.