Gangrenous pyoderma

Introduction The disease manifests as destructive necrotizing, non-infectious skin ulcers, and clinically, sputum-like nodules, pustules or hemorrhagic bullae. In the case of early nodular erythema or pustules, the disease can be attributed to vasculitis. The tender erythema of the nodule is red at first, and then becomes blue in the center, eventually forming an ulcer. One or more vesicular pustules, similar to acne, folliculitis, transient acantholytic dermatosis or herpes-like dermatitis. It has been confirmed that there is a serum cutaneous necrosis factor which causes skin necrosis in guinea pig skin, but its specificity is unknown.

Cause

It has been confirmed that patients with this disease are deficient in delayed response to DNCB, candida and streptokinase. This can explain that when the reticuloendothelial system is extremely low, new lesions can occur when there is slight damage or injury. This hypersensitivity can also be caused by acupuncture, especially in the acute phase of the disease and near the lesion. strong. It has been confirmed that there is a serum cutaneous necrosis factor which causes skin necrosis in guinea pig skin, but its specificity is unknown. Evidence of a well-recognized immune mechanism defect is that many patients have gamma globulin disease, atypical protein disease, T cell dysregulation, or phagocytic defects.

an examination

Related inspection

Physical examination of skin diseases, skin color, vascular ultrasound, skin test

In the case of early nodular erythema or pustules, it can be attributed to vasculitis. The tender erythema of the nodule is red at first, and then becomes blue in the center, eventually forming an ulcer. One or more vesicular pustules, similar to acne, folliculitis, transient acantholytic dermatosis or herpes-like dermatitis. Both lesions can occur at the same time, and can also be converted to each other. Skin lesions can occur in normal skin or areas of the original skin disease. Painful ulcers on the stalk edge and oozing yellowish green pus with malodor have diagnostic value. Oral high-dose corticosteroids are given once a diagnosis is made.

Differential diagnosis

Need to be differentiated from the following diseases:

1. Behcet's disease is sudden onset, and the pustule component is lymphocytes without ulceration and no scar after healing.

2. Postoperative progressive gangrene is more common in the chest or abdomen. It is often a single lesion that can separate micro-aerobic streptococcus from the lesion and is sensitive to antibiotics. 3.Meleney gangrene septic ulcer is similar to this disease, but nowadays Infections caused by Clostridium are not common.

4. Wegener granulomatosis has multiple organs to damage the lesion pleomorphism, the respiratory tract is a good site, C-ANCA positive.

5. The distribution of fulminant purpura lesions is extensive and progresses rapidly.

6. Amoebiasis, cryptococcosis and blastomy can be confirmed by microbiological and pathological examinations.

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