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Pyoderma gangrenosum associated with hidradenitis suppurativa.

A Ah-Weng1, J A A Langtry, S Velangi

  • 1Department of Dermatology, Monklands Hospital, Lanarkshire and Sunderland Royal Hospital, Sunderland, UK. allanahweng@yahoo.co.uk

Clinical and Experimental Dermatology
|October 4, 2005
PubMed
Summary

Pyoderma gangrenosum (PG) rarely occurs with hidradenitis suppurativa (HS). This study details six patients with HS for over 20 years who developed severe PG, often requiring intensive treatment.

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Area of Science:

  • Dermatology
  • Internal Medicine
  • Systemic Inflammatory Diseases

Background:

  • Pyoderma gangrenosum (PG) is a neutrophilic dermatosis often associated with systemic diseases.
  • The co-occurrence of PG and hidradenitis suppurativa (HS) is infrequently documented in medical literature.
  • Understanding the relationship between these conditions is crucial for effective patient management.

Purpose of the Study:

  • To describe the clinical characteristics and treatment outcomes of patients with pyoderma gangrenosum (PG) developing on a background of hidradenitis suppurativa (HS).
  • To highlight the rarity and potential severity of PG in HS patients.
  • To investigate potential associated conditions in patients with co-existing PG and HS.

Main Methods:

  • Retrospective case series describing six patients diagnosed with both PG and HS.

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  • Data collection included patient demographics, disease history, onset of PG relative to HS, and treatment regimens.
  • Analysis of associated systemic conditions and the course of PG refractory to standard treatments.

    • Main Results:

    • Six patients (3 male, 3 female; aged 35-51 years) presented with PG on a background of HS, with PG onset after at least two decades of HS.
    • Four patients experienced severe, refractory PG requiring aggressive treatments like high-dose corticosteroids, ciclosporin, IV immunoglobulin, and IV cyclophosphamide.
    • Associated conditions included severe adolescent acne vulgaris (3 patients), systemic lupus erythematosus (1 patient), and chronic iron-deficiency anemia (1 patient).

    Conclusions:

    • Pyoderma gangrenosum can develop in patients with long-standing hidradenitis suppurativa, often presenting as a severe and refractory condition.
    • No clear correlation was observed between the disease activity of PG and HS.
    • The presence of other systemic conditions like acne vulgaris, SLE, and anemia warrants consideration in patients with co-existing PG and HS.