Pyoderma gangrenosum is a rare, inflammatory skin disease where painful pustules or nodules become ulcers that progressively grow. Pyoderma gangrenosum is not infectious.Treatments may include corticosteroids, ciclosporin, infliximab, or canakinumab.The disease was identified in 1930. It affects approximately 1 person in 100,000 in the population. Though it can affect people of any age, it mostly affects people in their 40s and 50s. Types
There are two main types of pyoderma gangrenosum:
the typical ulcerative form, which occurs in the legs
an atypical form that is more superficial and occurs in the hands and other parts of the bodyOther variations are:
Peristomal pyoderma gangrenosum comprises 15% of all cases of pyoderma
Bullous pyoderma gangrenosum
Pustular pyoderma gangrenosum
Vegetative pyoderma gangrenosum

Presentation
Associations
The following are conditions commonly associated with pyoderma gangrenosum:
Inflammatory bowel disease:
Ulcerative colitis
Crohns disease
Arthritides:
Rheumatoid arthritis
Seronegative arthritis
Hematological disease:
Myelocytic leukemia
Hairy cell leukemia
Myelofibrosis
Myeloid metaplasia
Monoclonal gammopathy
Autoinflammatory disease:
Pyogenic sterile arthritis, and acne syndrome (PAPA syndrome)

Causes
Though the cause is not well understood, the disease is thought to be due to immune system dysfunction, and particularly improper functioning of neutrophils. In support of an immune cause, a variety of immune mediators such as interleukin (IL)-8, IL-1β, IL-6, interferon (IFN)-γ, granulocyte colony-stimulating factor, tumor necrosis factor alpha, matrix metalloproteinase (MMP)-9, MMP10, and elafin have all been reported to be elevated in patients with pyoderma gangrenosum.Also in support of an immune cause is the finding that at least half of all pyoderma gangrenosum patients suffer from immune-mediated diseases. For instance, ulcerative colitis, rheumatoid arthritis, and multiple myeloma (MM) have all been associated with pyoderma gangrenosum.
Gamma globulins are a class of globulins, identified by their position after serum protein electrophoresis. The most significant gamma globulins are immunoglobulins (antibodies), although some immunoglobulins are not gamma globulins, and some gamma globulins are not immunoglobulins. Use as medical treatment
Gamma globulin injections are usually given in an attempt to temporarily boost a patients immunity against disease. Injections are most commonly used on patients having been exposed to hepatitis A or measles, or to make a kidney donor and a recipient compatible regardless of blood type or tissue match. Injections are also used to boost immunity in patients unable to produce gamma globulins naturally because of an immune deficiency, such as X-linked agammaglobulinemia and hyper IgM syndrome. Such injections are less common in modern medical practice than they were previously, and injections of gamma globulin previously recommended for travelers have largely been replaced by the use of hepatitis A vaccine. Gamma globulin infusions are also used to treat some immunological diseases, such as idiopathic thrombocytopenia purpura (ITP), a disease in which the platelets are being attacked by antibodies, leading to seriously low platelet counts. It appears that gamma globulin causes the spleen to ignore the antibody-tagged platelets, thus allowing them to survive and function. Another theory on how gamma globulin administration works in autoimmune disease is by overloading the mechanisms that degrade gamma globulins. Overloading the degradation mechanism causes the harmful gamma globulins to have a much shorter half of the life in sera. Intravenous immunoglobulin (IVIG) may be used in Kawasaki disease.