Is pyoderma gangrenosum associated with solid malignancies? Insights from a population‐based cohort study

Abstract

Background: The question of whether solid malignancies (SMs) are associated with pyoderma gangrenosum (PG) remains to be conclusively answered.Objective: To evaluate the risk of SM among patients with PG and the odds of PG after a diagnosis of SM.Methods: A population-based retrospective cohort study was conducted to study the risk for SM in patients with PG (n = 302) as compared with age-, sex-and ethnicity-matched control subjects (n = 1799). A case-control design was used to estimate the odds of PG in those with a preexisting history of SM. Results:The prevalence of a preexisting SM was comparable in patients with PG and controls (7.5% vs. 8.8%, respectively; P = 0.490). The odds of having PG following a diagnosis of a SM was not statistically increased (OR, 0.85; 95% CI, 0.53-1.36). The incidence of SM was 6.8 (95% CI, 3.5-12.2) and 7.9 (95% CI, 6.1-10.1) per 1000 person-years among patients with PG and controls, respectively. Patients with PG were not more likely to develop SM as compared to controls (HR, 0.86; 95% CI, 0.44-1.69). Patients with a dual diagnosis of PG and SM were older and had more frequent comorbid conditions and increased mortality.Conclusions: SM is not associated with provoking PG, and patients with PG are not at an increased risk of developing SM. A thorough routine screening for SM in patients with new-onset PG is an unnecessary approach based on the study findings.

Association of All-Cause and Cause-Specific Mortality Risks With Pyoderma Gangrenosum

“…Previous studies have indicated that 30% to 70% of patients have comorbid disorders, although the prevalence varies widely among studies: 16%-47% for IBD, 4% to 10% for inflammatory arthritis, and 1% to 7.5% for solid tumors. 10, [12][13][14][15] The differences could be explained by 2 reasons: (1) in contrast to our study, most previous studies have been hospital-based case-control studies, with many patients receiving treatment at tertiary medical centers, and 12 (2) to clarify the association between PG and comorbidities, we considered PG to be associated with a specific disease only when the other diagnosis was made before or within 1 year after PG diagnosis.…”

Development of morphea during Nivolumab treatment

“…These include morbilliform and lichenoid eruptions, pruritus and vitiligoid lesions. [1][2][3][4] The development or aggravation of pre-existing psoriasis, blistering diseases such as pemphigoid 1,2,4,5 or other connective tissue diseases have also been described. Nivolumab and pembrolizumab monoclonal antibodies bind to the programmed death receptor-1 (PD1), blocking its ligands interaction and consequently Figure 2 Histopathology (H&E staining), A 920 magnification, B 9100 magnification, C 9200 magnification: There is atrophy of the epidermis and collagen sclerosis affecting both papillary and reticular dermis.…”

“…Immune-related adverse effects (IRAEs) are the most common type of immunotherapy toxicity and can affect any organ. [1][2][3]…”

Pyoderma gangrenosum: A review of patient's demographics, disease and treatment in 118 patients

“…Immune-related adverse effects (IRAEs) are the most common type of immunotherapy toxicity and can affect any organ. [1][2][3]…”

“…Only 7.6% had a solid malignancy, which is of questionable significance given a recent study showing no significant association between PG and solid malignancy. 3 Obesity was found in 61%, almost double the Australian population incidenceapproximately 31%. 4 This may be both a contributing and a complicating component.…”