When should I consider referring a patient with pyoderma gangrenosum to a dermatologist for further management?

Consider referring a patient with pyoderma gangrenosum to a dermatologist promptly when the diagnosis is uncertain, the lesion is rapidly progressing, or there is significant pain and tissue destruction despite initial management. Early specialist involvement is crucial to confirm diagnosis, as pyoderma gangrenosum can mimic infections or malignancies, and to initiate appropriate immunosuppressive therapy to prevent further tissue damage. Referral is also indicated if the patient has associated systemic diseases (such as inflammatory bowel disease or arthritis) requiring multidisciplinary care, or if first-line treatments in primary care fail to control the condition. Specialist input is essential for biopsy interpretation, systemic immunomodulatory treatment decisions, and monitoring for complications (Suárez-Pérez et al., 2012; ¹).

In summary, urgent referral to dermatology should be considered for any suspected pyoderma gangrenosum case that is atypical, severe, or refractory to initial treatment, ensuring timely diagnosis and management to reduce morbidity (Suárez-Pérez et al., 2012; ¹).