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Published on: February 16, 2024
Clinicopathological features and prognosis of pyoderma gangrenosum in Korea: A single centre, retrospective,
Young Jae Kim1, Keon Hee Lee1, Chong Hyun Won1
1Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Background:
Pyoderma gangrenosum is a rare autoinflammatory neutrophilic dermatosis that rapidly evolves. However, little is known about the clinicopathological features and prognosis of pyoderma gangrenosum.
Aims:
We aimed to document clinicopathologic and prognostic data of the patients with pyoderma gangrenosum.
Methods:
In this retrospective observational study, we reviewed case records of patients diagnosed with pyoderma gangrenosum between 1999-2019.
Results:
Fifty-three patients were identified by reviewing medical records for skin biopsy; of these, 37 were men and 16 were women. Mean age at onset was 43.3 ± 18.5 years. The most frequently affected area was the lower extremities (60.4%), followed by the head and neck (17.0%). The most common subtype was ulcerative (47.2%), followed by bullous (22.6%). 30 cases had underlying diseases and the most common were malignancy (24.5%), followed by inflammatory bowel diseases (18.9%). The proportion of cases with history of trauma were significantly higher in post-operative type (100%) as compared to the bullous type (8.3%). Histologic features of granulation tissue were frequently found in post-operative type (66.7%) and bullous type (58.3%). Granulomas were predominantly found in bullous type (58.3%). Age <60 years appeared to be significantly associated with multiple lesions. Partial-to-complete remission was observed in 40 cases (75.5%). Nine (17.0%) cases experienced recurrence with a median progression-free period of six months (interquartile range of 3.0-9.0 months). Cases with underlying hematologic disorders and the bullous subtype were significantly associated with early recurrence.
Limitations:
This study was a single-centre study with a retrospective design.
Conclusion:
Pyoderma gangrenosum appears to have ethnic differences. Underlying haematologic disorders and bullous subtype have a worse prognosis. However, the type of histopathology did not correlate with the clinical outcome of pyoderma gangrenosum.
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