Check for updatesReceived:16 March 2023 Accepted:1 May 2023D010.1111/1346-8138.16845GUIDELINESDERMATOLOGYClinical guidance of pyoderma gangrenosum 2022Toshiyuki Yamamoto Kenshi Yamasaki2 Keiichi Yamanaka3 Mayumi Komine4Tamihiro Kawakamis Osamu Yamamoto5 Takuro Kanekura7 Tetsuya Higuchi8Toshiya Takahashi2 Yoshiaki Matsushima3 Nobuyuki Kikuchi1Japanese Dermatological Association Pyoderma Gangrenosum Treatment Guidelines DraftingCommitteeFukushima Medical University.AbstractFukushima,Japan2Tohoku University,Sendai,JapanPyoderma gangrenosum(PG)is a rare,neutrophilic skin disease.For the purpose of ac3Mie University,Tsu,Japancurate diagnosis and proper treatment of PG,the Japanese clinical practice guidance for4Jichi Medical University,Shimotsuke,PG developed by the Japanese Dermatological Association was published in 2022.In thisJapanguidance,clinical aspects,pathogenesis,current therapies,and clinical questions on PGSTohoku Medical and PhamaceuticalUniversity,Sendai,Japanare described from the viewpoints of current knowledge and evidence-based medicine.6Tottori University,Yonago,JapanHere,the English version of the Japanese clinical practice guidelines for PG is presented7Kagoshima University,Kagoshima,Japanand is intended to be widely referred to in the clinical examination and treatment of PG.Toho University Sakura Medical Center,Sakura.JapanKEYWORDSJapanese guidance,neutrophilic disease,pyoderma gangrenosumCorrespondenceToshiyuki Yamamoto,Fukushima MedicalUniversity.Fukushima,Japan.Email:toyamade@fmu.ac.jp1 INTRODUCTIONAfter the advent of a new treatment using biological prepara-tions in 2020,a campaign to increase the awareness of the diseasePyoderma gangrenosum (PG)is a typical neutrophilic dermatosis,inwas initiated.Prior to the preparation of these treatment guide-which activated neutrophils play an important role.The type that pres-lines,guidance on the use of adalimumab for PG was prepared inents with ulcer is typical,and solitary or multiple proliferative,gangre-2021.1 Following this,the present guidelines for the treatment ofnous,and deep rodent ulcers develop,primarily in the lower legs.SincePG were prepared under such circumstances with the aim of offer-this disease is frequentlyaccompanied bydisorders such as inflammatorying up-to-date knowledge (as of January 2022)about the diseasebowel disease,rheumatoid arthritis,and blood diseases,its diagnosis andstate and treatment of PG to physicians treating PG in Japan.It istreatment often require cooperation with other medical departments.also intended to contribute to improvements in patients'quality ofTherefore,spreading knowledge about the disease to physicians otherlife(QOL)through early detection and appropriate treatment of PGthan dermatologists contributes to its early detection.However,for thethrough the use of a handbook for daily practice,including treat-reasons described below,the disease is not easy to diagnose.ment and lifestyle guidance.This isthe secondary publication of the pa
