How is PG Diagnosed?

PG is challenging to diagnose because it is rare, and there are no specific lab tests or biomarkers to confirm it. Diagnosis is based on a combination of clinical features (how the ulcer looks and behaves) and ruling out other potential causes (ulcers from poor circulation, infections, skin cancer, etc.). A skin biopsy is sometimes helpful but does not always confirm a diagnosis. Because PG can look like many other skin conditions, it is often misdiagnosed at first.

Are there tools to help with PG diagnosis?

There are currently three diagnostic frameworks that can be used to diagnose PG, but there is no consensus on which one is best. 

• PARACELSUS: A points-based system that evaluates how likely PG is based on symptoms, ulcer characteristics, and lab findings. A higher score means that PG is more likely.
• Delphi Criteria: A list of major and minor criteria of PG that was decided on by a group of experts. Diagnosis of PG is suspected if certain combinations of criteria are met. 
• Su Criteria: A simpler set of clinical guidelines based on how the ulcer appears, how it progresses, and how it responds to treatment.

These tools can help guide diagnosis but should always be used in addition to clinical judgement from an experienced provider.