Pyoderma Gangrenosum: A Retrospective Study of Clinical Charac­teristics, Comorbidities, Response to Treatment and Mortality Related to Prednisone Dose

• Main Authors: Louise Schøsler, Karsten Fogh, Rikke Bech
• Format: Article
• Language: English
• Published: Society for Publication of Acta Dermato-Venereologica 2021-04-01
• Series: Acta Dermato-Venereologica
• Subjects: pyoderma gangrenosum; comorbidity; immunosuppressants; prednisone; mortality rate
• Online Access: https://www.medicaljournals.se/acta/content/html/10.2340/00015555-3776

Pyoderma gangrenosum is an uncommon ulcerative neutrophilic dermatosis. Clinical presentation, location and associated diseases are diverse. Treatment of pyoderma gangrenosum includes treating the underlying comorbidity supplemented with topical and/or systemic agents. However, treatment is often challenging. The aim of this study was to explore the diversity of pyoderma gangrenosum and its treatments. A total of 64 patients with pyoderma, at the Department of Dermatology, Aarhus University hospital, Denmark, were included in the study. The patients’ records were reviewed over a 6-year period for clinical presentation, associated diseases, treatments and response to treatment, time to mortality after diagnosis and prednisone dose over time. A variety of accompanying comorbidities were found, including a possible association with diabetes. Tumour necrosis α inhibitors were used as third- or fourth-line therapy, but showed the shortest time to remission, and use of prednisone was associated with a higher mortality rate. These findings are discussed in relation to future approaches to treatment of pyoderma gangrenosum.