Pyoderma gangrenosum‐like oral ulcerations in an elderly patient

Abstract

Clinicians should always take into consideration that PG in the oral mucosa is a recalcitrant ulcer and can precede the development of underlying clonal malignancy.

Pyoderma Gangrenosum–Like Lesion in an Older Adult

“…5,6 Pyoderma gangrenosum has seldom been described in elderly persons, and few case reports have documented the challenges that arise in the diagnosis and management of PG in this population. [7][8][9] Older adults are a challenging treatment population because it is often necessary to manage comorbid conditions while avoiding polypharmacy. 10 These challenges can be particularly critical for the management of PG, which is known to co-occur with other conditions, such as inflammatory bowel disease and rheumatoid arthritis.…”

“…5 Current PG management guidelines have not differentiated between old and young patients, 6 Pyoderma gangrenosum can be more challenging to manage in older adults with increased risk of comorbidity and mortality, 12,13 although few case reports have described the unique concerns of older patients. [7][8][9] A previous study evaluated 23 patients with PG between the ages of 30 and 89 years (mean age, 62.8 years). 13 The study observed 5 deaths, and among these individuals, the average age at diagnosis was much older (age 78.8 years) compared with other patients.…”

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

“…In the case report by Paramkusam et al 5 , the authors opted for a medication with prednisolone and dapsone soon after tooth extractions. In other studies 14,23 , at the time of mucosal biopsy, the patients were already under steroid treatment for their systemic condition. In a further case where patient had PG-like lesions requiring oral biopsy 9 , but no specific intervention was detailed.…”

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

“…In a case series involving 16 patients with cutaneous PG, 83% of cases were diagnosed based on the clinical features and the exclusion of infectious and neoplastic causes [4]. Reports of extensive ulceration bordered by an overlying fibrinopurulent membrane with heavy neutrophilic infiltration of the lamina propria are consistently seen in biopsied cases [5,12,16,18,23,24,26,[29][30][31][32]. Neutrophils can have an altered appearance [20].…”

“…In addition to systemic corticosteroids, local ulcer care is suggested to enhance patient comfort and prevent secondary microbial or fungal infections. Chlorhexidine 0.12% mouth rinse can be used to achieve this in oral PG [21,24,31]. Topical clobetasol propionate (Dermovate 0.05%) or Tacrolimus (Protopic 0.1 or 0.03%) can be used as adjuvants to systemic therapy to relieve symptoms [9,23].…”