Oral Pyoderma Gangrenosum: Diagnosis, Treatment and Challenges: A Systematic Review

Bissonnette, Caroline; Kauzman, Adel; Mainville, Gisèle N.

doi:10.1007/s12105-017-0804-3

Cited by 25 publications

(15 citation statements)

References 62 publications

(119 reference statements)

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“…In fact, Ashchyan et al completed a retrospective cohort study and found that lower extremity involvement can be found in 62% of patients, as opposed to head or neck involvement which occurs in 5% of pyoderma gangrenosum cases [3]. Despite this fact, multiple case reports have been published where head and neck involvement was the only presenting clinical feature of pyoderma gangrenosum [4][5][6][7][8][9][10]. In fact, Yco et al reported a case similar to our patient with neck, lower extremity, and oral pyoderma gangrenosum in a patient with a background history of inflammatory bowel disease [10].…”

Section: Discussionmentioning

confidence: 99%

Pyoderma Gangrenosum as a Presenting Feature of Undifferentiated Spondyloarthropathy with Erosive Inflammatory Arthritis

Kaler

Sheffield

Thway

et al. 2020

Case Reports in Rheumatology

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Pyoderma gangrenosum is a rare inflammatory condition with varying clinical presentations and severity. It is commonly seen in association with an underlying condition, most common of which is inflammatory bowel disease. We report a case of a 26-year-old male who came to the emergency department with increasing lower extremity ulcers, intermittent hematochezia, and pain in the small joints of his hands. After excluding a broad list of differentials for lower extremity ulcers, the diagnosis of pyoderma gangrenosum was made. He was also found to have erosive changes at multiple proximal interphalangeal joints and jug-like syndesmophytes at T12 and L1 on CT scan. Although there was evidence of a spondyloarthropathy, there was no evidence of inflammatory bowel disease on colonoscopy, psoriasis, or sexually transmitted infections. After multiple failed trials of medications including azathioprine and sulfasalazine, 4 weeks of Adalimumab resulted in rapid healing of pyoderma gangrenosum lesions and improvement in his synovitis. Coupled together, this suggests a diagnosis of pyoderma gangrenosum associated with undifferentiated spondyloarthropathy and erosive inflammatory arthritis. This case is suggestive of spondyloarthropathy going underdiagnosed and untreated in other patients with pyoderma gangrenosum as lower extremity ulcerations can be the primary complaint for seeking treatment. Although rare, axial spondyloarthropathy associated with pyoderma gangrenosum should be kept as an associated differential diagnosis when faced with pyoderma gangrenosum.

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Section: Discussionmentioning

confidence: 99%

Pyoderma Gangrenosum as a Presenting Feature of Undifferentiated Spondyloarthropathy with Erosive Inflammatory Arthritis

Kaler

Sheffield

Thway

et al. 2020

Case Reports in Rheumatology

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“…Bissonnette et al 7 ). Hernandez-Hernández-Martín et al reported the case of a 84-years-old woman presenting a PG oral ulcer 14 not associated with skin lesions, which resolved a few weeks later by treatment with oral steroids.…”

Section: Andmentioning

confidence: 99%

“…The authors concluded that prophylactic corticosteroid could be of help in case of surgical interventions 12 . A further recommendation was recently reported by Bissonnette et al 7 who stated that "surgical debridement of PG lesion should be avoided without concomitant medically-induced immunosuppression or pre-operative corticosteroids as surgery has been demonstrated to exacerbate cutaneous PG".…”

Section: Introductionmentioning

confidence: 99%

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Dental treatment of a rare case of pyoderma gangrenosum with aggressive periodontal disease

Carmagnola¹,

Pispero²,

Canciani³

et al. 2018

The Journal of the American Dental Association

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“…The ulcers develop a purulent cover, which rapidly becomes malodorous due to secondary infection. PG is often associated with severe pain [ 3 ]. The cause of PG is unknown, but 50-70% of cases are associated with other diseases, mainly inflammatory bowel disease (IBD), arthritis and lymphoproliferative disorders.…”

Section: Introductionmentioning

confidence: 99%

Pyoderma Gangrenosum of the Preauricular Area with Ulcerative Colitis: A Case Report and Review

et al. 2018

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Pyoderma gangrenosum (PG) is primarily, a sterile, inflammatory, neutrophilic dermatosis, characterized by recurrent cutaneous ulceration with mucopurulent or hemorrhagic exudate. The incidence of PG is uncertain, but it is estimated to be about 3-10 patients per million per year. It occurs most commonly on the lower legs, but has been reported at other sites of the body as well. The causes of PG are unknown, but about 50-70% of cases are associated with other diseases, mainly inflammatory bowel disease. We hereby report a case of PG in a 21-year-old male, with a history of ulcerative colitis (UC). After appropriate diagnostic methods including biopsy for pathologic confirmation, sigmoidoscopy and computed tomography, we excluded other diseases and the lesion was diagnosed as PG. We then carried out regular dressing of the wound, while UC was treated with steroid and immunosuppressant medication, with inputs from the department of gastroenterology during the hospital stay. There occurred recurrence of the skin lesion, 7 months after discharge, after which they improved. UC has been in the remission state as per the follow-up, since 2 years.

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Oral Pyoderma Gangrenosum: Diagnosis, Treatment and Challenges: A Systematic Review

Cited by 25 publications

References 62 publications

Pyoderma Gangrenosum as a Presenting Feature of Undifferentiated Spondyloarthropathy with Erosive Inflammatory Arthritis

Pyoderma Gangrenosum as a Presenting Feature of Undifferentiated Spondyloarthropathy with Erosive Inflammatory Arthritis

Dental treatment of a rare case of pyoderma gangrenosum with aggressive periodontal disease

Pyoderma Gangrenosum of the Preauricular Area with Ulcerative Colitis: A Case Report and Review

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