Pyoderma Gangrenosum: Associations Revisited

Abstract

Fourteen cases of pyoderma gangrenosum were seen over a period of 24 years at the Hull Royal Infirmary Dermatology Department. Several associated conditions were found. Seven cases were associated with rheumatoid arthritis of which five were sero-positive, including one with Felty's syndrome. One case was associated with both ulcerative colitis and psoriasis; one with polycythemia rubra vera; two patients had diverticular disease including one who also had rheumatoid arthritis; one had positive syphilis serology. In three cases there was no significant associated disease identified. Ten out of the fourteen cases were women, indicating a female preponderance by a ratio of about 2F:1M; a figure similar to that stated by Seitzinger. The age of presentation ranged from 30 to 80 years.

Bilateral Pyoderma Gangrenosum Following Bilateral Reduction Mammoplasty: Case Report

“…Hepatitis C or other viral infections, Wegener's granulomatosis, systemic lupus erythematosus and other autoimmune diseases are other likely causes. [9][10][11][12][13] Twenty-three percent of cases are induced and aggravated by minor trauma or surgery and this, points out the pathergy phenomenon in the PG. It was also reported as a complication of various surgical interventions, such as hernioplasty, cardiac surgery, cesarean section and breast surgery.…”

“…The most common diseases associated with PG are ulcerative colitis, Crohn's disease and rheumatoid arthritis. [9][10][11][12][13] Management of PG involves medical control of the inflammatory phase of PG and local wound care.…”

Leg Ulcers in Patients with Myeloproliferative Disorders: Disease- or Treatment-Related?

“…All the ulcers observed in our patients occurred in a leg with superficial or deep venous insufficiency, relevant arterial disease or deep-vein thrombosis. The differential diagnosis encompasses cutaneous leukocytoclastic vasculitis [32], cryoglobulinemia [32]and pyoderma gangrenosum [4, 5, 33], which should be ruled out if clinical signs are present.…”

“…Myeloproliferative disorders may lead to leg ulceration as a consequence of impaired cutaneous microcirculation or they may be associated with ulcerating skin disorders, such as cryoglobulinemia and pyoderma gangrenosum [1, 2, 3, 4, 5], the latter often presenting atypically [6, 7, 8]. However, leg ulceration in myeloproliferative disorders has also been attributed to side effects of the drugs used to treat the underlying disorder.…”

Topical Treatment of Pyoderma gangraenosum

“…In 1974, Peachey [5] reported 1 case of PG of the scalp with a good response to topically applied 0.1% betamethasone 17-valerate lotion under occlusion. Four additional patients suffering from PG and treated with topical steroids have been reported by Ko et al [6]. In all 4 patients, this treatment was effective.…”