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Conditions

Pyoderma Gangrenosum

Picture of Pyoderma Gangrenosum

Pyoderma Gangrenosum, or PG, is an extremely rare condition involving skin ulcers. These have a blue-black edge and will discharge pus, which may have an unpleasant odour. The condition is usually very painful, to the point where it may be debilitating for the sufferer. The ulcers usually start as a small bump or blister which will spread and become ulcerated extremely fast. A speedy diagnosis is advisable if PG is suspected. PG can affect people of all ages, but is more common amongst adults, in particular those who have an underlying disease.

PG has been known to occur in places where there is trauma or previous injury to the skin (this process is known as pathergy). It most commonly manifests on the legs, but can also affect hands and other parts of the body. It is often linked with having a poor immune system and complications can arise from bacterial infections or associated diseases. Swabs and blood tests are therefore common when diagnosing PG and a skin biopsy may also be necessary.

The cure for PG often varies depending on the individual case, but will be overseen by a specialist dermatologist. The condition is managed through a combination of treatments, from dressing the wound and courses of steroids to immunosuppression, whereby the immune system is controlled by drugs. In cases where ulcers are particularly large, surgery may also be needed. The healing process is a slow one and scarring is highly likely.

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There was a man from Scotland I think. Who was on the show maybe a year back , becaurse of pyoderma. I cant find the episode, is there anyone who can help me find that episode ?





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My mama is suffering from PG.she is 61.i really dont know how to help her pain even though she took pain med, i thought my mam is the only paitiant i m glad to find u peaple.my mam is diagnosed for PG seans october 2014, its really pain full sweelling opening of skin docters recognize it after they done several sergery on her right leg. She is in steroid and cyclosporine seems to help but after we decrease the cyclosporine it come again in her right hand she seems disscuraged i would like to find peaple like her, that she can share her pain with some one who experience the same kind, she share her feeling with i am glad to find u peaple.





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Hi! Thank you all for sharing your stories and spreading encouragement to all of us who are struggling!! :-) So many of your stories really touched my heart and made me feel, I'm really now alone! As, you do when you have such a rare terrible disease. So here's a little of my story... I am a 23 yr old female. I live in Cleveland, Ohio. I have been struggling with this horrific disease PG for 5 years now, but was just recently diagnosed within the past year! I have seen over 20 doctors and none of them knew what was wrong with me and flat out told me they have never seen anything like my case and didn't even want to start! Then, finally I found a good dermatologist at University Hospitals in Cleveland, Ohio. We have tried close to 20 treaments and not one has worked yet!! But, she kept working with me and trying and never gave up on me, which any other drs. have never done! As, of right now, I inject 40 Mg Humira weekly and 1 take 15 Mg of Methotrexate every week. And so far has made very little, if any progress. I am on a total of 15 medications all due to illnesses caused from this disease. Including I have to go see a pain management dr because my pain is so unbearable from the time I wake up, to the time I got to bed! I also, have several other medical conditions I have on top of this terrible disease alone such as, asthma, fibromyalgia, sleep apnea, polysistic ovarian syndrome, etc. My diagnosis of PG is only 80%. I was also, told I could have a disease that may not have ever been diagnosed, which results in no treatment. To all you suffering from PG, I just wanted to tell you I am so sorry what you all are going through and it's not fair! I understand what's it's like to go to the drs and get stared down like you are an alien because they have no clue what you are going through! I know how bad the pain is, when you just cry all day cuz the pain is so overbearing. I know the feeling of hopelessness, when treatment after treatment fails or you have lapse in treatment and your heart is split in two! I understand when your so depressed, you just don't want to get out of bed or don't do the stuff u love to do because you don't have a passion for them anymore or maybe hoped you never woke up cuz things felt so bad! I understand all this because I have these feelings and even more feelings everyday of my life!! I have a beautiful 5 year old daughter and she is the only thing that keeps me going! I made a promise to her, that mommy was going to try her best to get better and I'm going to keep that promise, till the day I die! I want to make that girl proud and have her look back and see her mother is a survivor!!! Thank you all for letting me share and those, who read my story! :-) Good luck to all and take care!! -Amy-





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Omg I'm reading these comments with flash backs ... I honestly think the only cure for PG is to have a total bowel removal !! I had ulcerative for many yrs until suddenly I fell very ill with PG, ulcers covering nearly 50% of my body !! This was 14 yrs ago when we had no internet and no answers for a diagnosis ... Until a biopsy proved to be PG . I had no choice only to have a complete bowel removal and to be left with an ileostomy... My PG Stopped growing and I total healed up after a few months .. 14 yrs later I still have the scars & a bag stuck to my tummy ... But I'm a mammy to a 9 yr old boy x x Good luck everyone

hello amy, i know what you are going through, our daughter Tracy has pg and has had for four years. We were told she is one of the top 5 severe cases in Australia.definatly not something we wanted to hear. Both legs and both arms, yes very very painful too much for anyone to endure, but endure she does. Every time we think we have got on top of it, it comes back two fold with new wounds.at present we are trialling an injection of a drug called stellar a so far so good.for the first time we are not getting new wounds every other day. Please keep in touch and let us know how you are going. We also have no contact with any other sufferer

HI I HAVE HAD TREATMENT FOR ?OSTEOMYELITIS ?ULCERS ON MY LEFT LEG FOR 4 YEARS 7 MONTHS 6 WEEKS AGO I WAS DIAGNOSED WITH PG.I STARTED IN DAPSONE AND DERMOVATE OINTMENT I HAVE SEEN 4 CONSULTANTS AND NOT ONE SEEMS TO BE ABLE TO HELP ME WITH THE DREADFUL PAIN THAT I HAVE. I HAVE A HIGH PAIN THRESHOLD BUT I CAN NOT SLEEP AND FIND MYSELF CRYING WITH THE PAIN DAY AND NIGHT, CAN ANYONE PLEASE TELL ME WHAT ANALGESICS WOULD HELP I DO NOT FEEL THAT I CAN COPE WITH THE PAIN MUCH LONGER AND IT IS SO MISERABLE FOR ME AND MY FAMILY TO BE IN SO MUCH PAIN





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Try diet.. I cut out everything for two months. All I ate was I blended up vegetables and fruit with water and ice... I couldn't walk I was so bad and I know the pain of feeling like your foot is going to explode just by your heart beating.. Keep your leg elated NEVER use polysporin!!! And if your desperate try the diet... I did it for 3 months and had a complete heal.. it comes back but I eat every well know and never had a bad breakout. .. when I feel it coming back on I cut out all processed foods and watch my meats because we eat what they eat... let me know if you try it and how quickly it heals :) feel better soon I know the pain &don't wish it on anyone

I have been broken out with sores fir 3yrs they have 6 biopsy on these sores they look like Pyro but comes back nothing the pain is so intense I can't stand it I have given up hope my middle back is the worse they r as big as quarters help does anyone know or could help me!





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After emergency hospital admittance, rounds of specialists, dermatologists, infectious disease md and the CDC in Atlanta I feel very lucky to have reached the PG diagnosis (much quicker than many) thru my hardworking PCP and the third dermatologist who worked cohesively w/him by gathering all the previous biopsies etc. and medical reports of previous physicians who refused to share data. I will say, if they had relied on biopsies alone I would be in sad shape right now... They developed a fluid (alter as needed) treatment plan of oral steroids and steroid cream and ointment applied to the singular large ulceration on my lower back. The pain is like no other. I share a deep, abiding sympathy for anyone who has not had their pain needs addressed. This is nearly a malpractice issue. While PG is rare, we do live in America, for the most part. There are enough internet documents (nearly) to assist any good MD in ruling out most other issues. The remaining defining characteristics of the PG ulcer get very close to a diagnosis. My PCP writes the script for any pain meds and he is quite sensitive to the "idea" that this pain is much like the pain of a burn victim. If there was no pain during healing that would be a bad sign. As the ulcer heals we see progress on the outside, however, remember this was created by the immune system turning on itself. Therefore it makes sense that the healing occurs from the inside out. We cannot see the cell or nerve damage that is regenerating under the layers of new skin. Hang in there to any/all who are still suffering. Press those PCP to assist with pain management and work with any other specialist. Your PCP is the 'hub' of your healthcare.... I had forgotten that.

Hi I've had pg since May of 2014 I'm 24 years old with SLE and RA I'm on humira and also doing steroid treatments it seems to me that they are finally down sizing but it's taking forever anyone know of any thing to help ease the pain besides the pain pills ? Any home remedies or certain things that helped ?





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Hello, I was diagnosed with pg a year ago.. after several visits to the emergency and doctors having no idea what I had and making it it worse by cutting, poking and taking samples... I finally found a dr that made it her mission to find out what I had... What worked for me... diet... diet.. diet... I cut out everything except for fruits and vegetables for over two months (I know that seems extreme but if you are in as much pain as i was anything is worth a try)... my foot cleared up completely the dermatologist was amazed how quickly my open massive wound healed.. trust me I know the burning.. the feeling like my foot was made of glass and going to explode everytime my heart beat.. the pain so unbarable that you cry for no reason... I also kept my leg elevated as I couldn't walk it was so bad the elivation helped with some of the pain.. If your willing do do it. cut out everything processed.. I made drinks in a blender just vegetables, fruit, ice and water... it worked better than any steroid.. I was also told DO NOT USE polysporin!!

I was diagnosed 1/19/2015. I have two wounds one on each leg. How are you dealing with the intense burning pain?





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My Dr. Gave me hydrocodone. I also kept my leg elevated to reduce inflammation. Stay as positve as you can. It took me 4 months to clo se the holes in my leg.cyclosorine and steroids did the trick. Then humira. Good luck sweetie.I feel for you. Nobody can understand the pain.

Hi there I have heard honey is good does anyone know which was is best to use and what brand?





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The product is called Medi-Honey. I don't think a prescription is needed to purchase as I've seen it on medical supply websites. It is best used under the direction of a dermatologist or wound care specialist. Is there a Wound Care Center in your area? I've had PG with a large wound involving my toes for the past 6 yrs. I've used Medi-Honey for the past year and a half and it has cleaned up my wound tremendously.

Thank you cynitha I will let my mum know ..

PROTOPIC OINTMENT 0.1% (tacrolimus ointment)

Kenalog 40 mg/ ml with 50% saline mix in and around the wound worked with one treatment over 11years ago and has kept new lesions that I can feel under my skin from surfacing. I've never had a steroid regiment.

My mother in law is 70 and had PG for over a year now. She is currently in hospital has been for 12 weeks..she has had cyclosporine which nearly crippled her, been on steroids for months and months and still is on a high dose. She has had one course of inflixamib and waiting for 2nd but can't due to constant recurring infections which the hospital cannot control. They even tried maggots last week to clean the wound which has gone so deep it's nearly to the bone but they reacted to her wound and made it even worse. What can we do or is there somewhere else we can try and get more help. We are in aberdeenshire getting treatment at Aberdeen royal infirmary.





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I had pyo for 6 months before i got results from mayo clinic. I was on cyclosprine and i used algae pads to stick in the holes, then wrapped an una boot (medicated wrap) i changed it every 2 or three days. My holes were almost healed in 3 months. Ask ask ask lots of questions. I almost lost my leg because of lousy doctors.

PROTOPIC OINTMENT 0.1% (tacrolimus ointment)

My heart goes out to the poor lady. I was diagnosed with PG in the summer of 2006 at the age of 41. I visited the GP mid July with a red and swollen left foot which was assumed to have been caused by an insect bite. After multiple courses of antibiotics, elevation and frozen peas, things were not improving, only getting worse. Eventually after a couple of weeks, a small area opened up in the middle of my ankle bone. The pain had got so bad that I had to visit A & E where I was hooked up to intravenous anti biotics. The swelling improved but the pain was horrendous and the ulcer was growing fast. After around 3 weeks of dressings and no improvement, the tissue viability dept said I had to have the dead flesh removed via an operation or maggot therapy. Well, I didn't like the sound of the scalpel so opted for maggots. It has to be the most excruciating 3 days of my life with no sleep or relief from the pain and on top of that, had to go to the hospital to have the foul bandages changed. I'm not a drama queen but the whole pg ang maggot experience will stay with me forever, it's indescribable. Once the maggot pack was removed, the hole was huge and the ankle bone visible. Having suffered with psoriasis for many years, I already saw a dermatologist regularly but my usual Dr was still on leave and the one I saw said that it would clear up if I stopped using the hdroxyurea I had been using. It didn't. I could barely function, surviving on morphine and sleeping pills with my son being looked after by my parents. Luckily my own Dr returned to work and immediately ordered a biopsy and then pg confirmed. Treatment was prednisolone, and various dressings. Although the steroids were controlling the pain, it was constantly infected, lots of exodute and not really healing. The turning point was compression therapy (3 layer). The wound finally healed at the end of May 2007, around 11 months after the original trauma. PG will heal, I'm proof so please do not lose heart, something will work. I hear that the biological drugs which control inflammation can be really affective.

My father has just been diagnosed with PG. He has three ulcers, the largest affecting his right foot. The ulcer is so deep that his Achilles Tendon is exposed. He also suffers from rheumatoid arthritis and renal insufficiency, limiting enormously the kind of medicine he can take to control the horrendous pain he feels both on an on going basis and when the dressings are changed. I would appreciate enormously if you could suggest literature and specialists who can help us with pain management as well as treatment options.





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Im a 24 year old female who has just been diagnosed with Lupus Vasculitis and Raynaud's Disease on top of the chronic bronchitis i was born with, so i know how painful a pg ulcer is the doctors told me the same thing about there not being any cure for the disease but i believe that eating natural,healthy foods like raw meats fish,chicken,& turkey,fruits & vegetables,and exercising right can manage PG correctly. I've seen articles from Google online where people experiencing the same thing said it worked. But I think you shouldn't take no for an answer go to the county hospital in your area the doctors are great they helped me deal with my diagnosis they have me taking the same meds too & others along with it im sure they can help you and your son as well good luck :)) and May God Bless you and heal your little boy,I thought my situation was worse than everyone else's,and nobody should have to go through this but your little one definitely does not deserve such a thing.

PROTOPIC OINTMENT 0.1% (tacrolimus ointment)





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