Pathergy

Pathergy is a phenomenon in which minor trauma induces skin disease. It is a non-specific skin reaction to minor trauma, such as needle prick. The phenomenon is particularly associated with Behçet's disease, a rare, chronic, systemic autoinflammatory disorder.

Overview

Pathergy is a hyperreactivity of the skin in response to minimal trauma, which is a common feature of Behçet's disease. The reaction is characterized by the development of sterile pustules, nodules, or ulcers at the site of skin injury. The pathergy test, which involves intradermal skin pricking, is used as a diagnostic tool for Behçet's disease. However, the sensitivity and specificity of the test vary widely, and it is not universally accepted as a diagnostic criterion.

Clinical Presentation

The pathergy reaction typically presents as a small red bump (papule) or pustule, 1-2mm in diameter, that appears 24-48 hours after the skin is pricked. The reaction usually resolves within a few days to a week. In some cases, a pathergy reaction may be the first sign of Behçet's disease.

Pathophysiology

The exact mechanism of pathergy is not well understood. It is thought to involve an abnormal inflammatory response to injury, possibly related to an overactive immune system. Some studies suggest that the reaction may be due to an increased sensitivity to neutrophil activity, a type of white blood cell involved in inflammation.

Diagnosis

The diagnosis of pathergy is based on the clinical presentation and the results of the pathergy test. The test involves pricking the skin with a small needle and observing for a reaction. A positive test is indicated by the development of a papule or pustule at the site of the prick within 24-48 hours.

Treatment

There is no specific treatment for pathergy. Management is focused on treating the underlying disease, such as Behçet's disease, and managing symptoms. This may involve the use of medications to reduce inflammation and suppress the immune system.

See Also

• Behçet's disease
• Autoinflammatory diseases
• Neutrophil

References

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