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Drug-Induced Pyoderma Gangrenosum: A Review
Jane Y Wang1, Lars E French2, Neil H Shear3,4
1Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
American Journal of Clinical Dermatology
|June 19, 2017
Summary
Drug-induced pyoderma gangrenosum (PG) is a rare condition. Cocaine, isotretinoin, propylthiouracil, and sunitinib are frequently implicated, highlighting the need for clinical consideration of medications in PG diagnosis.
Area of Science:
- Dermatology
- Pharmacology
- Clinical Medicine
Background:
- Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis.
- Adverse drug reactions are a potential cause of PG.
Purpose of the Study:
- To review the clinical presentation and outcomes of drug-induced PG.
- To identify drugs commonly associated with PG development.
Main Methods:
- Literature search of PubMed, MEDLINE, and EMBASE for case reports of drug-induced PG.
- Utilized Naranjo criteria to assess the probability of drug causality.
- Analyzed 52 cases from 44 studies.
Main Results:
- Cocaine-induced PG showed a mean Naranjo score of 9.4 (definite adverse drug reaction).
- Isotretinoin, propylthiouracil, and sunitinib had mean Naranjo scores of 6.2, 6.8, and 7.4, respectively (probable adverse drug reactions).
Conclusions:
- Clinicians should consider medications as potential triggers for PG.
- Particular attention should be given to isotretinoin, propylthiouracil, sunitinib, and cocaine use in patients diagnosed with PG.
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