Which histopathologic findings suggest pyoderma gangrenosum?

Updated: Mar 09, 2020
  • Author: J Mark Jackson, MD; Chief Editor: William D James, MD  more...
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The histopathologic findings in pyoderma gangrenosum are not specific. However, a biopsy is suggested in almost all instances because it is useful in the exclusion of other diseases, such as infections and malignancy. Microscopic features include massive neutrophilic infiltration, hemorrhage, and necrosis of the overlying epidermis. Histologically, this finding may simulate an abscess or cellulitis, although no organisms are seen and cultures are generally negative or only demonstrate typical skin flora. Neutrophils are often around and within the vessel walls, but the full picture of vasculitis is generally absent.

In early disease, a mixed cell infiltrate may be present. Late in the process, granulation tissue may be present, but granuloma formation is generally believed to be incompatible with the diagnosis of pyoderma gangrenosum.

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