Proposed diagnostic criteria of classic, ulcerative pyoderma gangrenosum (2004)*

Major criteria (must have both):

Rapid progression of a painful, necrolytic cutaneous ulcer with an irregular, violaceous, and undermined border (1 to 2 cm per day or 50% increase in size within one month)

Other causes of cutaneous ulceration have been excluded (usually necessitates skin biopsy and laboratory investigations)

Minor criteria (must have two):

History suggestive of pathergy or clinical finding of cribriform scarring

Systemic disease associated with pyoderma gangrenosum (inflammatory bowel disease, arthritis, IgA gammopathy, or malignancy)

Histopathologic findings (sterile dermal neutrophilia, ± mixed inflammation, ± lymphocytic vasculitis)

Treatment response (rapid response to systemic glucocorticoid treatment)

IgA: immunoglobulin A.
* Subsequent diagnostic criteria have been published. Refer to UpToDate topics on pyoderma gangrenosum for additional information.

From: Su WP, Davis MD, Weening RH, et al. Pyoderma gangrenosum: clinicopathologic correlation and proposed diagnostic criteria. Int J Dermatol 2004; 43(11):790-800. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-4632.2004.02128.x. Copyright © 2004 International Society of Dermatology. Modified with permission of John Wiley & Sons Inc. This image has been provided by or is owned by Wiley. Further permission is needed before it can be downloaded to PowerPoint, printed, shared or emailed. Please contact Wiley's permissions department either via email: [email protected] or use the RightsLink service by clicking on the 'Request Permission' link accompanying this article on Wiley Online Library (http://onlinelibrary.wiley.com).

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Proposed diagnostic criteria of classic, ulcerative pyoderma gangrenosum (2004)*