Transcript

Windy Cole, DPM:

Yeah, PG is a difficult wound type to diagnose because there's really not one hallmark lab or test that you perform. It's actually a diagnosis of exclusion. Remember that the underlying pathophysiology is driven by the immune disease. So, to ensure that we arrive at the accurate diagnosis, it's typically a good idea to get a skin biopsy. And this way it can help us exclude other conditions that might present similarly, such as infectious ulcers or vasculitic ulcers also. Routine tests can be taken and they're of limited value, but again they can kind of rule out other differential diagnoses. So, antinuclear antibody studies, other labs that show inflammation, those might be helpful again in ruling out some other systemic issues. 

Another hallmark of PG is when we put patients on steroids, either topical or systemic steroids, we usually see a rapid response if, in fact, it is PG that's causing the wound. So that's definitely something that you should note on your charts and on your medical records, how patients respond to any steroid treatment as well. 

So understanding the underlying wound pathophysiology and how the wound responds to treatment is really important to understand, you know, first make the diagnosis of pyoderma, but then understand what the best clinical treatment algorithm would be for these types of wounds.