One that healed up

This picture is shows a lot of details. Two of the arrows are pointing to the puffy bands that surround my Pyoderma. These bands are the source of most of the pain. Between these two rings there appears to be a gap of healthy unaffected skin. I have no idea why or how this healthy skin remains but it would probably help answer questions about Pyoderma's existence.

The small dark spot with an arrow is actually an original Pyoderma boil that never really grew. It was there for about two weeks and then it just started to heal on its own. I would occasionally put Neosporin on it but that was it.

As of now the black spot is gone. I just have a small scar. Why did this Pyoderma boil heal while the other two continued to grow?

Hippocrates

After all of the tests have been done my situation has been narrowed down to two possible situations which are common for people experiencing Pyoderma, Inflammatory Bowel Disease (IBD) or Leukemia. I have been flagged for some above average items that are common but could point to Leukemia but my money would be on the IBD. I used to have the symptoms about two years ago. I thought I was becoming lactose intolerant. I have a father and niece that are both very intolerant to dairy. I chalked it up as one of those things due to getting older. I don't have any of the symptoms of IBD currently but I was told that I didn't have to prior to developing Pyoderma.

If one has IBD or Crohn's disease, Pyoderma development is a possibility. From the readings I have done on Pyoderma it appears that persons that suffer from Crohn's develop the most stubborn or recalcitrant Pyoderma.

Ring of fire

This picture illustrates the thick band or ring that forms around Pyoderma. Strips or strings of dead tissue can be seen around the edges. I have never intentionally removed dead tissue. I usually leave it alone and it just comes off when bandages are removed or maybe while in the shower.

These swollen rings will exist for about a week then they disappear. The center area of the wound doesn't really change. Most of the changes happen on the outer edges.

My complication has had a little complication

I was running some errands and while I was a half a block from my building I noticed a squishing sound in my left shoe. I didn't remember stepping into anything so when I looked down I noticed that my bandage wrapped around my leg which is usually white was in fact now red, deep red. And my shoe was full of blood. I could see the blood trails running down my ankle and disappearing into my shoe.

When I got into my apartment i went into the bathroom to inspect my leg. The bandages, so soaked with blood, just slid off my leg. When this happened blood actually sprayed out of my shin like a constant squirt. It sprayed all over the walls, the floor and also into the bathtub, only stopping after I held a washcloth to the area, applying pressure. I of course not being a doctor or even an Eagle Scout for that matter did what I would normally do, freak out in panic.

To see my blood spray out like that really freaked me out. I was afraid I would pass out because of all of the blood lost. The carpet in my hallway was ruined and the bathmat was soaked. The pic shows on the right side that my bathmat is glistening. For the record bathmats do not glisten. It was soaked through to the floor.

The horror..

I have received the biopsy information and everything came back negative. No skin cancer, no fungus, nor bacterial. Its autoimmune. My immune system seems to be attacking myself.

So it seems I have typical garden variety Pyoderma Gangrenosum (PG). PG doesn't just come about on its own. It is has an underlying cause. Think of PG being smoke and this unknown underlying cause as the fire. Treat the underlying cause and everything else will take heal as well. The next step is to find this cause.

And that's not all..

Its starting to look nasty. One can see red pockmarks on the left side of my wound. These are a result of me scratching the skin. It also was due to some of the medical tape I was using. When it was pulled from my skin, it actually took little strips off as well! Ok, so no more plastic medical tape in the house! I then switched to paper or cloth tapes. These worked fine.

About this time I had already had a steroid injection into the wound by my dermatologist. Often Pyoderma will respond to steroids by shrinking and healing. I would get two steroid shots over a two week period with no noticeable results.

Also about this time I began to suffer from stinging pain while in the shower. The mere spray of some water would be enough for me to jump. In an effort to keep the area clean I would let my tub head run cool water down my leg and over my wound. It was producing a yellow fluid that would soak my dressings in about two hours. I'm not sure if its edema fluid, plasma or whatever. I refuse to have my sore covered in this stuff so I would run some water over it, cool or cold water. For some reason warm water made the sore hurt.

Still here..

The picture illustrates that the wound has gotten larger and it has those thick blue almost purple bands surrounding the entire sore. It also has a soft pinkish hue that surrounds the area. This redness is more than the usual erythema but actually Cellulitis. I was taking antibiotics to help reduce this redness but It would turn out that either the meds weren't working or that I wasn't taking enough.

Recalcitrant fugger

It used to be two separate sores but as one can see they have joined forces. The dark bump near the top is the location of my biopsy a few days earlier. My leg may seem really fat or puffy because it is. I seem to have developed edema as well. My other leg is normal.

At this time when I take my usual shower I drizzle a little Hibiclens on the wound and let the shower wash it off. Hibiclens is great antibacterial soap that are used by all hospitals and physicians. It can be a tad expensive and it can stain towels or clothing but it is well worth it. It is important to note that at no time should anyone with Pyoderma Gangrenosum undertake a debridement of the wound. To do so may excite the area and cause the lesion to grow even faster. After my biopsy, the dermatologist said that the area may speed up with its growth because of the trauma caused by the biopsy. It did effect the wound but not the area of the biopsy. Strange..

My Second Doc

My dermatologist told me to have a physical examination so he referred me to an internal medicine physician. I had actually came across my documentation from my last complete examination. It had been three years exactly, to the day. I gave these to the doc so that she might have some type of reference. I had no use for them. I was asked a bunch of questions about my past, lifestyle questions, family histories and the like.

I had some blood drawn, had a chest X ray and left a urine sample. I also had my testicles checked for lumps. This actually hurt. Like getting kicked in da balls. She really pinched them. She then put those rubber gloves on and as Peter Griffin said I had my 'innocence taken'. I had my prostate examined. She said everything seemed normal.

So now I had to wait a few days to get my lab results back. Normally I wouldn't be worried but this sore on my leg wasn't getting better and I was beginning to worry.

A trip to the doc..

This pic is the first of my sore. Its just a gauze pad being held on with clear medical tape.



Over the weekend nothing really changed. I was given a prescription for some antibiotics and for some anti inflammatory salve, Mupirocin. I was to put the salve around the edges of my sore a few times a day. This was easy because the border of my lesion was raised, however a moment after this salve was applied, i felt a stinging sensation. Not good.

At this second visit my doc was surprised that I wasn't complaining about pain. I said that I felt a slight sting while in the shower, from the soap, and from the Mupirocin but that was about it. It was about this time that I was explained what he thought I actually had on my leg. A very rare lesion called Pyoderma Gangrenosum but to be 100% sure a biopsy had to be performed. The doc had on a body length smock, rubber gloves and a clear face shield. He said that it was gonna hurt a little and that I may suffer some bleeding. Ok, that's fine. I've never been afraid of needles, blood, cutting as long as I don't have to actually see any cutting. The whole procedure lasted about 15 minutes. I felt some stinging but nothing major. I could see his little table with a strip of my tissue, about the size of a finger nail. He was cutting it into bits and dropping them into these little vials. He said that he was doing this so that he could send them off to different labs for examination. He was looking for bacterial, fungal, cancer and whatever else.

They wrapped my leg up after all was finished and now we had to wait for the results. He asked me to call the office in a few days for these results. It as this same week that I was scheduled to have a physical by another doc, internal medicine. So this leg wound is starting to have me run around..

Uh, what the heck is that..!?

I noticed a boil or 'infected hair' type lesion on my left leg. I slapped some Neosporin on it and went out the door. It was unusually painful for such a small bump, smaller than a dime. About a week later nothing was healing. It was getting larger, about the size of the ring on a can of soda. It had a raised ring around a lowered center. The center of my 'boil' was a dull white. It looked like a miniature cream pie. It didn't hurt at all but it looked gross and strange.

I went to a dermatologist and had come to the understanding that this thing was more than a garden variety boil. When I went to see the doctor he asked me a bunch of questions. What do I do for work? Do I handle hazardous chemicals? Who goes to a physician for an infected hair?

In my examination he made me undress and checked my entire body for other sores which I didn't have and also measured my leg sore. He then drew a line, using a magic marker, around my entire wound adding less than an inch of border. He said If over the weekend this thing grows enough to cross any of this marker call me on my cell phone. I was told to come into the office on monday and he was going to do a biopsy of my sore. Ok, sounds fine to me. It was this first consultation that I heard the name Pyoderma Gangrenosum.