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Underlying Systemic Diseases in Pyoderma Gangrenosum: A Systematic Review and Meta-Analysis
Khalaf Kridin1, Arnon D Cohen2,3, Kyle T Amber4
1Department of Dermatology, Rambam Health Care Campus, PO Box 9602, Haifa, 31096, Israel. dr_kridin@hotmail.com.
American Journal of Clinical Dermatology
|May 4, 2018
Summary
More than half of patients with pyoderma gangrenosum have an associated systemic disease, most commonly inflammatory bowel disease or arthritis. This systematic review synthesizes prevalence data for these conditions.
Area of Science:
- Dermatology
- Internal Medicine
- Epidemiology
Background:
- Pyoderma gangrenosum (PG) diagnosis can be challenging due to varied presentations.
- Limited consensus exists on the prevalence and types of systemic diseases associated with PG.
Purpose of the Study:
- To systematically review and synthesize data on the prevalence of systemic diseases in patients diagnosed with pyoderma gangrenosum.
- To provide a comprehensive overview of the epidemiological landscape of comorbidities in PG.
Main Methods:
- A systematic review and meta-analysis of observational studies published between 1823 and 2017.
- Searches were conducted across MEDLINE, EMBASE, and Scopus databases.
- Pooled prevalence rates were estimated using random-effects models, with evidence quality assessed by a modified Newcastle-Ottawa Scale.
Main Results:
- Twenty-one studies including 2611 patients with PG were analyzed.
- The overall pooled prevalence of associated systemic diseases was 56.8%.
- Most common conditions included inflammatory bowel disease (17.6%), arthritis (12.8%), hematological malignancies (8.9%), and solid malignancies (7.4%). Pathergy phenomenon was noted in 16.3% of cases.
Conclusions:
- Over half of pyoderma gangrenosum patients exhibit an underlying systemic disease, with IBD and arthritis being most frequent.
- Pooled prevalence estimates for solid malignancies were higher than previously reported.
- High heterogeneity necessitates cautious interpretation of findings.
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