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Annales de Dermatologie et de Vénéréologie
Volume 142, n° 8-9
pages 502-505 (août 2015)
Doi : 10.1016/j.annder.2015.06.007
Actualité sur la prise en charge du pyoderma gangrenosum en 2015
Developments in pyoderma gangrenosum therapy in 2015
 

P. Modiano
 Service de dermatologie, université catholique de Lille, hôpital Saint-Vincent-de-Paul, boulevard de Belfort, BP 387, 59020 Lille, France 

Résumé

Le diagnostic du pyoderma gangrenosum en 2014 reste clinique avec la forme principale d’ulcère à bord violacé mal limité. Les critères diagnostiques ont été modifiés récemment avec comme intérêt d’éliminer les diagnostics différentiels (10 % de séries rétrospectives de pyoderma). Les pathologies associés sont fréquentes (75 %) avec l’émergence des maladies endocriniennes (36,7 %), et les classiques pathologies digestives, rhumatologiques et hématologiques. De nouveaux concepts, PAPA, PASH syndromes, appartenant aux maladies auto-inflammatoires, permettent d’avoir de nouvelles perspectives thérapeutiques. Le traitement de première ligne reste la corticothérapie avec en cas de corticodépendance, l’association aux immunosuppresseurs. Les biothérapies sont prometteuses en deuxième ligne. Dans les pyoderma syndromiques, les inhibiteurs de l’interleukine-1 sont prometteurs.

The full text of this article is available in PDF format.
Summary

Diagnosis of pyoderma gangrenosum in 2014 continues to be made on clinical grounds, with the main form comprising an ulcer having poorly delineated purplish edges. The diagnostic criteria have been recently modified so as to rule out differential diagnoses (10% of retrospective series of pyoderma patients). The condition is commonly associated with other diseases (75%) such as emerging endocrine diseases (36.7%), and classical gastrointestinal, rheumatological and haematological diseases. The new concepts of PAPA and PASH syndromes, belonging to the category of auto-inflammatory diseases, provide new therapeutic perspectives. Corticosteroids continue to be the first-line therapy, along with immunosuppressant drugs in the event of steroid dependence. Second-line treatments consisting biotherapies show promise and interleukin-1 inhibitors have exhibited potential against pyoderma syndrome.

The full text of this article is available in PDF format.

Mots clés : Pyoderma gangrenosum, PASH, Maladies auto-inflammatoires

Keywords : Pyoderma gangrenosum, PASH, Auto-inflammatory diseases




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