title: Pyoderma gangrenosum requiring inpatient management: a report of 26 cases with follow up.
abstract: We present a case series of inpatients with pyoderma gangrenosum (PG), an ulcerative neutrophilic skin condition of unknown aetiology. Twenty-six patients were admitted with PG, nine men and 17 women. At the time of the chart review, seven patients (26.9%) had died. Patients had a mean of 2.0 active ulcerative lesions and 22 patients' ulcers (84.6%) were on the lower limb. Systemic diseases were coexistent in 15 patients (57.7%), the most common being rheumatoid arthritis (19.2%). Thirty-eight wound cultures were taken and were positive for Staphylococcus aureus in 22 cases (57.8%) and Pseudomonas aeruginosa in 20 (52.6%). After prednisolone, cyclosporin was the next most commonly prescribed systemic therapy (34.6%). Surgical debridement was undertaken in seven cases (26.9%) and two patients had skin grafts. Upon discharge from hospital, 21 patients' ulcers (80.8%) had improved. At 6 months 50% showed complete ulcer healing. Our results highlight the potential severity of PG requiring hospital admission, the need for aggressive therapy and the overall high associated morbidity and mortality.
authors.affiliation: Departments of Medicine and Dermatology, St Vincent's Hospital, Melbourne, Victoria, Australia. adnama22@yahoo.com
authors.forename: Amanda
authors.initials: A
authors.lastname: Saracino
authors.forename: Rob
authors.initials: R
authors.lastname: Kelly
authors.forename: Danny
authors.initials: D
authors.lastname: Liew
authors.forename: Alvin
authors.initials: A
authors.lastname: Chong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications; D003093:Colitis, Ulcerative / Q000150:complications; D003424:Crohn Disease / Q000150:complications; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D017511:Pyoderma Gangrenosum / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D013211:Staphylococcus aureus / Q000302:isolation & purification; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D011239:Prednisolone