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Inflammatory arthritis-associated pyoderma gangrenosum: a systematic review
Erika Sawka1, Allison Zhou1, Emile Latour2
1Department of Dermatology, Oregon Health & Science University, Center for Health and Healing, 3303 SW Bond Ave, Portland, OR, 97239, USA.
Clinical Rheumatology
|May 18, 2021
Summary
Inflammatory arthritis, particularly rheumatoid arthritis, often precedes pyoderma gangrenosum. Biologic therapies show promise in treating this condition, offering effective outcomes alongside corticosteroids.
Area of Science:
- Dermatology
- Rheumatology
- Immunology
Background:
- Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis linked to systemic inflammation.
- Limited data exists on the association between PG and inflammatory arthritis outside of case studies.
Purpose of the Study:
- To characterize the association between pyoderma gangrenosum and inflammatory arthritis.
- To analyze patient demographics, clinical presentation, and treatment outcomes in this patient subset.
Main Methods:
- Systematic review of PubMed, EMBASE, and Scopus databases.
- Inclusion of 129 patients with inflammatory arthritis and PG from 1399 screened articles.
- Descriptive statistics and stratified analysis by arthritis type.
Main Results:
- Rheumatoid arthritis (RA) was the most common associated arthritis (50.4%), followed by IBD-associated (10.9%) and psoriatic arthritis (8.5%).
- Joint symptoms preceded PG in most cases (median 10 years).
- Corticosteroids and biologic therapies achieved ulcer improvement/resolution in 71.4% and 67.3% of cases, respectively, with infliximab, adalimumab, and anakinra being most successful.
Conclusions:
- Inflammatory arthritis, especially RA, frequently precedes PG.
- Biologic medications are effective treatment options for PG associated with inflammatory arthritis, potentially aiding in corticosteroid-sparing therapy.
- The specific type of inflammatory arthritis did not significantly impact treatment success or healing time.
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