378 Real-world utilization of Delphi consensus diagnostic criteria for pyoderma gangrenosum referrals

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by chronic, painful ulcerations. PG challenging to diagnose due its variable presentation, clinical overlap with other conditions, and the absence of defining markers. Consensus diagnostic criteria have recently been proposed for diagnosis but remain underutilized. Our objective was assess use published Delphi (DC) in patients suspected PG, evaluate differences met between true ulcers alternate diagnoses. We prospectively identified referred one dermatologist over four-year period. diagnosed based on DC criteria. Overall, 27 referrals were identified. Most >55 years (70.4%, 19/27) female (59.3%, 16/27). Median follow-up 23 months. Patients most commonly (51.9%, 14/27) after median 6.5 months care. Twenty-four (88.9%) found diagnoses, namely exogenous injury-induced ulcer (37.0%, 10/27), venous/vascular (22.2%, 6/27), vasculitis (11.1%, 3/27), infection 3/27). Three (11.1%) PG. The major criterion 13 (48.1%) referrals. Of minor criteria, morphology (55.6%, 15/27) met, while cribriform scarring (7.4%, 2/27) least met. findings show that consensus can aid systematic evaluation which lead optimization provider heuristics benefit reducing misdiagnosis rates, delays care, iatrogenic exacerbation conditions.