Pyoderma gangrenosum: clinical characteristics, associated diseases, and responses to treatment in a retrospective...

The aim of this study was to describe the clinical characteristics of patients with pyoderma gangrenosum (PG) and to evaluate the association between these characteristics, the treatment followed, and the patient responses, relapses, and mortality rates.

This retrospective cohort study identified adults diagnosed with pyoderma gangrenosum over the duration of 10 years.

Thirty-one patients were evaluated; 58% were women and 55% were older than 65 years, 87% presented with the ulcerative type, and 77% showed lower limb compromise. Approximately 74% of the cases were associated with systemic disease. The most frequent were inflammatory bowel disease (32%) and hematologic malignancies (22%). Pyoderma gangrenosum preceded the associated disease in 26% of the patients, all of them were younger than 50 years old (P = 0.059). In 83% of the latter, the diagnosis of associated disease followed the cutaneous lesions within 24 months. Among the 10 patients with inflammatory bowel disease, six required biologic agents to control the pyoderma gangrenosum (P = 0.002).

Despite the advances that have been made in the treatment of patients with pyoderma gangrenosum, we are still unclear as to the optimal way in which patients should be followed up once the diagnosis is made. The results of our study underline the importance of doing screening tests to detect potential disease, emphasizing patients younger than 50 years old, for a minimum time lapse of 24 months. It is essential to design randomized-controlled trials to understand the most appropriate and effective ways of following up patients with pyoderma gangrenosum.