Clinical characteristics, associated comorbidities, and treatment approaches in pyoderma gangrenosum: a single-center...

Pyoderma gangrenosum (PG) is a rare destructive neutrophilic dermatosis of unknown etiology, associated with systemic diseases in approximately 50% to 75% of cases.

We conducted a search of the hospital database to retrieve medical records of patients diagnosed with PG at our facility between 1995 and 2019. The diagnosis was validated through clinical characteristics, histopathological examination, and necessary tests to rule out other dermatoses. Data on demographics, disease presentation, comorbidities, and treatment strategies were collected and evaluated.

The analysis included 44 patients, 27 (61.4%) females and 17 (38.6%) males. The median age at presentation was 46.5 years (range 15-73). The most common location was the lower leg, in 32 (72.7%) patients. The ulcerative variant was found in 37 (84.1%) patients. In 11 patients (25%) an association with inflammatory bowel disease (IBD) was found. Hematological disorders occurred in five (11.4%) patients and rheumatoid arthritis in four (9.1%). Treatment was started with systemic corticosteroids (CS) in 36 (83.7%) patients, and pulse corticosteroid therapy was administered in five (11.4%) patients. The most frequently used steroid-sparing agent was dapsone, in 18 (40.9%) patients.

PG often presents with associated systemic conditions, but it may also appear idiopathically. CS remain the mainstay of treatment, complemented by immunosuppressants and biologics such as infliximab for IBD-associated cases.