Pyoderma gangrenosum and its impact on quality of life: a multicentre, prospective study

Ighani, Arvin; Almutairi, Dalal; Rahmani, Armin; Weizman, Adam V.; Piguet, Vincent; Alavi, Afsáneh

doi:10.1111/bjd.17347

Cited by 16 publications

(34 citation statements)

References 8 publications

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“…Mean DLQI in our study was 8.6 (±7.6, range: 0‐29), reflecting a moderate effect of PG on quality of life (Table 5). Previous studies reported DLQI scores of 8.4‐15.0 1 . Presence of pain with PG has been shown to be a strong contributor to increasing DLQI scores in previous studies, and our data reflected the same 1,3 .…”

Section: Discussionsupporting

confidence: 85%

“…1 Presence of pain with PG has been shown to be a strong contributor to increasing DLQI scores in previous studies, and our data reflected the same. 1,3 In our study, SATMED-Q scores decreased linearly with increased pain level, and increased linearly with satisfaction with pain control (Table 4). 10 Those whose pain control was provided by dermatologists vs other specialties had higher SATMED-Q scores (79.2 ± 11.5 vs 73.7 ± 17.4, respectively) (Table 4).…”

Section: Discussionsupporting

confidence: 51%

“…outcomes measures. 1,2 Although satisfaction with treatment is associated with increased compliance and improved outcomes, there are no studies that explore this association in patients with PG. 4,5 In this study, we dissect PG treatment satisfaction and PG's effect on quality of life (QOL) into non-modifiable and potentially modifiable considerations.…”

mentioning

confidence: 99%

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Treatment of pyoderma gangrenosum: A multicenter survey‐based study assessing satisfaction and quality of life

Hobbs

Byler

Latour

et al. 2021

Dermatologic Therapy

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Pyoderma gangrenosum (PG) lacks consensus regarding treatment, and no prior studies assess treatment satisfaction in PG. The objective of this study was to determine patient-reported satisfaction in the treatment of PG, and associations with satisfaction. Methodology was a multicenter cross-sectional survey for patients who received systemic medication(s) to treat PG. Thirty-five patients completed the survey (mean age: 54.0 years, 65.7% female, response rate: 81.4%). Mean (± SD)

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 51%

See 1 more Smart Citation

Treatment of pyoderma gangrenosum: A multicenter survey‐based study assessing satisfaction and quality of life

Hobbs

Byler

Latour

et al. 2021

Dermatologic Therapy

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“…3 Studies relating to PG are also challenged by the lack of a PGspecific severity scale and validated tools for assessing the effectiveness, efficacy and safety of therapeutics. [3][4][5] This results in the absence of a uniform therapeutic standard of care, complicating treatment selections.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, treatment options are limited and nonstandardized due to the scarcity of validated outcome measurement instruments for PG, as well as the limited number of clinical trials and randomized controlled trials (RCTs) 3. Studies relating to PG are also challenged by the lack of a PG‐specific severity scale and validated tools for assessing the effectiveness, efficacy and safety of therapeutics 3–5. This results in the absence of a uniform therapeutic standard of care, complicating treatment selections.…”

mentioning

confidence: 99%

Identification and evaluation of outcome measurement instruments in pyoderma gangrenosum: a systematic review*

Hobbs

Huang

et al. 2020

Br J Dermatol

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Summary Background Pyoderma gangrenosum (PG) is a rare autoinflammatory skin condition that causes tissue destruction and subsequent painful ulcers. To date, there are no core domains or instruments for assessing PG severity in clinical trials, and current treatment paradigms rely on outcome measurements that have not been well characterized in the literature. Objectives To perform two systematic reviews that (i) identify the outcome measurement instruments used in PG clinical trials and their corresponding domains and (ii) identify any associated validation studies and evaluate their measurement properties and methodological quality. Methods We systematically searched the MEDLINE and Embase databases for PG outcome measurement instruments. We also systematically searched for PG instrument validation studies. We evaluated the measurement properties and methodological quality of validation studies using the 2018 COSMIN Risk of Bias checklist. Results In total, seven clinical trials were included. These studies utilized a total of 20 different instruments, including 11 physician‐reported instruments, eight patient‐reported instruments and one composite instrument. Among these, 85% of the instruments lacked any validation data. Of the remaining three validated instruments (speed of healing, physician global assessment and resolution of inflammation), methodological quality was not available for half of the COSMIN categories. Conclusions We identified 17 non‐validated outcome measurement instruments used in PG clinical trials. We conclude that PG validation studies are required for existing instruments, and new instruments need to be developed to inform the consensus process for the development of a core outcome set for PG. What is already known about this topic? Pyoderma gangrenosum (PG) is a rare autoinflammatory skin condition that has been characterized by multiple outcome measurement instruments in clinical trials. However, there is no consensus on the most validated and appropriate outcome measurement instruments. What does this study add? This study identifies and evaluates 20 unique outcome measurement instruments for PG in the literature. Of these 20, 17 lack any instrument validation data, highlighting the need for future studies. What are the clinical implications of this work? Despite the current use of several outcome measurement instruments, future studies should explore the validation surrounding these instruments, as no instruments can currently be recommended.

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Refractory pyoderma gangrenosum in Caucasian adolescent with Takayasu arteritis and life‐threatening infections

Yeo,

Labbouz,

Lawrance

et al. 2024

JEADV Clinical Practice

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Pyoderma gangrenosum (PG) in Caucasians with Takayasu's arteritis (TA) is uncommon. We described a case of refractory PG in an 18‐year‐old Caucasian man with TA since the age of 10 and was treated with corticosteroids, methotrexate, anti‐TNF therapy (adalimumab), anti‐CD20 therapy (rituximab), cyclophosphamide and most latterly tocilizumab and leflunomide. He has vascular stenosis complicated with renovascular hypertension and is steroid‐dependent. He presented with a 6‐week history of a left cheek rapidly enlarging lesion associated with pain, bleeding and purulent discharge not responding to flucloxacillin. Incisional biopsy suggested PG. He later developed similar lesions on the volar aspect of the right hand and at venepuncture sites. Despite topical immunosuppressive medication and high‐dose pulsed intravenous methylprednisolone, the left cheek lesion continued to grow rapidly. These painful, unsightly ulcers caused significant psychosocial stress and limited his daily life. Following a multidisciplinary team (MDT) discussion, tocilizumab was switched to abrocitinib. While initial improvement of lesions was observed, he subsequently developed an acneiform eruption which evolved into PG and became superinfected with herpes zoster virus and Staphylococcus aureus, requiring hospitalisation for intravenous (IV) acyclovir and antibiotics. Following several MDT discussions, abrocitinib was discontinued and a new regimen consisting of ciclosporin, dapsone and enhanced frequency IV immunoglobulin (IVIg) every 2 weeks was initiated, effectively stabilising his PG. This case highlights the rare association of PG and TA in Caucasians, the complexities of managing PG complicated by severe infections and underlying immunodeficiency, and the significant psychosocial burden of PG.

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Pyoderma gangrenosum and its impact on quality of life: a multicentre, prospective study

Cited by 16 publications

References 8 publications

Treatment of pyoderma gangrenosum: A multicenter survey‐based study assessing satisfaction and quality of life

Treatment of pyoderma gangrenosum: A multicenter survey‐based study assessing satisfaction and quality of life

Identification and evaluation of outcome measurement instruments in pyoderma gangrenosum: a systematic review*

Refractory pyoderma gangrenosum in Caucasian adolescent with Takayasu arteritis and life‐threatening infections

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