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Rheumatoid arthritis and pyoderma gangrenosum: a population-based case-control study
Khalaf Kridin1, Giovanni Damiani2,3, Arnon D Cohen4
1Lübeck Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany. dr_kridin@hotmail.com.
Clinical Rheumatology
|July 3, 2020
Summary
Rheumatoid arthritis (RA) significantly increases the risk of developing pyoderma gangrenosum (PG) by over threefold. Patients with RA should be aware of this heightened risk and potential precipitating factors for PG.
Area of Science:
- Dermatology
- Rheumatology
- Epidemiology
Background:
- The association between pyoderma gangrenosum (PG) and rheumatoid arthritis (RA) lacks investigation in controlled studies.
- The specific risk of PG in RA patients remains unestablished.
Purpose of the Study:
- To evaluate the association between RA and the subsequent development of PG.
- To characterize RA-associated PG patients compared to other PG cases.
Main Methods:
- A population-based case-control study design was employed.
- 302 PG patients were compared with 1497 matched controls for RA presence.
- Logistic regression models were used for statistical analysis.
Main Results:
- RA prevalence was significantly higher in PG patients (4.7%) versus controls (1.5%).
- RA was associated with a >3-fold increased odds of developing PG (OR, 3.29), persisting after sensitivity analyses and confounder adjustment.
- RA typically preceded PG diagnosis by an average of 9.2 years, and RA-associated PG patients were older at onset.
Conclusions:
- Rheumatoid arthritis elevates the risk of pyoderma gangrenosum by more than threefold.
- Physicians should recognize this increased PG risk in RA patients.
- Advising RA patients to avoid PG precipitating factors is recommended.
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