Poor Prognosis of Arthritis-Associated Pyoderma Gangrenosum

Charles, Carlos A.; Bialy, Tracy L.; Falabella, Anna; Eaglstein, William H.; Kerdel, Francisco A.; Kirsner, Robert S.

doi:10.1001/archderm.140.7.861

Cited by 37 publications

(25 citation statements)

References 13 publications

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“…In a study covering 2 years 78.9% of PG-ulcers in general healed versus only 23.4% in arthritis-associated PG [27]. In such cases PAPA syndrome has to be considered [28].…”

Section: Clinical Presentationmentioning

confidence: 99%

Pyoderma gangrenosum – a review

Wollina

2007

Orphanet J Rare Dis

237

246

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Pyoderma gangrenosum (PG) is a rare noninfectious neutrophilic dermatosis. Clinically it starts with sterile pustules that rapidly progress and turn into painful ulcers of variable depth and size with undermined violaceous borders. The legs are most commonly affected but other parts of the skin and mucous membranes may also be involved. Course can be mild or malignant, chronic or relapsing with remarkable morbidity. In many cases PG is associated with an underlying disease, most commonly inflammatory bowel disease, rheumatic or haematological disease and malignancy. Diagnosis of PG is based on history of an underlying disease, typical clinical presentation, histopathology, and exclusion of other diseases that would lead to a similar appearance. The peak of incidence occurs between the ages of 20 to 50 years with women being more often affected than men. Aetiology has not been clearly determined yet.The treatment of PG is a challenge. Randomized, double-blinded prospective multicenter trials for PG are not available. The best documented treatments are systemic corticosteroids and ciclosporin A. Combinations of steroids with cytotoxic drugs are used in resistant cases. The combination of steroids with sulfa drugs or immunosuppressants has been used as steroid-sparing modalities. Antitumor necrosis alpha therapy in Crohn's disease showed a rapid response of PG. Skin transplants and the application of bioengineered skin is useful in selected cases as a complement to the immunosuppressive treatment. Topical therapy with modern wound dressings is useful to minimize pain and the risk of secondary infections. Despite recent advances in therapy, the prognosis of PG remains unpredictable.

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“…In a study covering 2 years 78.9% of PG-ulcers in general healed versus only 23.4% in arthritis-associated PG [27]. In such cases PAPA syndrome has to be considered [28].…”

Section: Clinical Presentationmentioning

confidence: 99%

Pyoderma gangrenosum – a review

Wollina

2007

Orphanet J Rare Dis

237

246

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“…Rheumatoid arthritis is associated with almost all forms of ND but is more frequent in PG. 35 The medical literature contains many isolated reports of associations between ND and other conditions. In many cases, these associations are considered as fortuitous.…”

Section: Associated Systemic Diseasesmentioning

confidence: 99%

From acute febrile neutrophilic dermatosis to neutrophilic disease: Forty years of clinical research

Wallach

Vignon‐Pennamen

2006

Journal of the American Academy of Dermatology

199

122

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“…Nearly 50% of patients have an underlying disorder, of which inflammatory bowel disease (IBD) such as ulcerative colitis and Crohn's disease, occurs often (10-15%) [4] But also different types of arthritis, hemotologic and liver diseases as well as cancer, systemic lupus erythomatosis, sarcoidosis, HIV, pregnancy [6,7] appear mostly before, but also during or after the outbreak of PG. When arthritis is associated, PG-ulcers only heal in 23.4% compared to 78.9% without arthritis [8]. There is no pathognomonic or specific histology.…”

Section: Discussionmentioning

confidence: 99%

Pyoderma Gangcrenosum in a Breast Cancer Patient: Report of a Case and Review of the Literature~!2010-03-24~!2010-04-03~!2010-05-07~!

Peeters¹,

Trinh²,

Verkinderen³

et al. 2010

TOBCANJ

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Pyoderma gangrenosum (PG) is a primarily sterile neutrophilic dermatosis. It starts spontaneously or due to pathergy (25-50%) with very painful ulcers with bluish borders, which grow rapidly and give expanding tissue necrosis. General incidence is estimated at 1/100000 per year. In this report a breast cancer patient developed PG due to surgical correction of a retracted scar of a lumpectomy. Diagnosis was made after her apparent inflammatory breast did not respond to broad spectrum antibiotics and became rapidly necrotic. This remained limited to the area of prior radiotherapy. Good response to systemic corticosteroids confirmed diagnosis of PG.

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Poor Prognosis of Arthritis-Associated Pyoderma Gangrenosum

Cited by 37 publications

References 13 publications

Pyoderma gangrenosum – a review

Pyoderma gangrenosum – a review

From acute febrile neutrophilic dermatosis to neutrophilic disease: Forty years of clinical research

Pyoderma Gangcrenosum in a Breast Cancer Patient: Report of a Case and Review of the Literature~!2010-03-24~!2010-04-03~!2010-05-07~!

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