Pyoderma gangrenosum: a report of 21 cases.
BACKGROUND
Pyoderma gangrenosum (PG) is an uncommon, destructive, cutaneous ulceration, belonging to the neutrophilic disease spectrum. It is associated with systemic disease in 50% of cases.


METHODS
We report a retrospective study of 21 cases of PG. All cases studied fulfilled the following criteria: (i) clinical features of PG; (ii) histopathology consistent with a diagnosis of PG, and excluding other specific dermatoses.


RESULTS
The average age of our patients was 41.8 years. The male to female ratio was 1.1. The typical ulcerative variant was found in 17 patients, bullous PG in two patients, and the granulomatous variant in two patients. Sixty-two per cent of our patients had lesions on their lower legs. Two patients had neutrophilic pulmonary involvement concurrent with the ulcers. An association with other internal diseases was noted in 12 patients. Histopathologic study showed vasculitis in 13 patients. Of these, 11 were leukocytoclastic and the others predominantly lymphocytic.


CONCLUSIONS
PG is a rare disease, with the ulcerative variant being most frequent. The lower legs are the most commonly affected sites. The recurrence rate in our study was about 46% regardless of the treatment prescribed. Pulmonary involvement was fatal in two patients.
Mlika
Rym Benmously
RB
Department of Dermatology, Military Hospital of Tunis, Tunis, Tunisia.
Riahi
Imed
I
Fenniche
Samy
S
Mokni
Mourad
M
Dhaoui
Mohamed Raouf
MR
Dess
Néjib
N
Dhahri
Amel Ben Osman
AB
Mokhtar
Insaf
I
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002991:Clofazimine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D012189:Retrospective Studies
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002991:Clofazimine