title: Associated factors and comorbidities in patients with pyoderma gangrenosum in Germany: a retrospective multicentric analysis in 259 patients.
abstract: BACKGROUND
  Pyoderma gangrenosum (PG) is a rarely diagnosed ulcerative neutrophilic dermatosis with unknown origin that has been poorly characterized in clinical studies so far. Consequently there have been significant discussions about its associated factors and comorbidities. The aim of our multicenter study was to analyze current data from patients in dermatologic wound care centers in Germany in order to describe associated factors and comorbidities in patients with PG.
  
  
  METHODS
  Retrospective clinical investigation of patients with PG from dermatologic wound care centers in Germany.
  
  
  RESULTS
  We received data from 259 patients with PG from 20 different dermatologic wound care centers in Germany. Of these 142 (54.8%) patients were female, 117 (45.2%) were male; with an age range of 21 to 95 years, and a mean of 58 years. In our patient population we found 45.6% with anemia, 44.8% with endocrine diseases, 12.4% with internal malignancies, 9.3% with chronic inflammatory bowel diseases and 4.3% with elevated creatinine levels. Moreover 25.5% of all patients had a diabetes mellitus with some aspects of potential association with the metabolic syndrome.
  
  
  CONCLUSIONS
  Our study describes one of the world's largest populations with PG. Beside the well-known association with chronic bowel diseases and neoplasms, a potentially relevant new aspect is an association with endocrine diseases, in particular the metabolic syndrome, thyroid dysfunctions and renal disorders. Our findings represent clinically relevant new aspects. This may help to describe the patients' characteristics and help to understand the underlying pathophysiology in these often misdiagnosed patients.
authors.affiliation: Department of Dermatology, Venereology and Allergology, University School of Medicine Essen-Duisburg, Hufelandstrasse 55, Essen 45122, Germany. joachim.dissemond@uk-essen.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Al Ghazal
authors.forename: Katharina
authors.initials: K
authors.lastname: Herberger
authors.forename: Jörg
authors.initials: J
authors.lastname: Schaller
authors.forename: Anke
authors.initials: A
authors.lastname: Strölin
authors.forename: Norman-Philipp
authors.initials: NP
authors.lastname: Hoff
authors.forename: Tobias
authors.initials: T
authors.lastname: Goerge
authors.forename: Hannelore
authors.initials: H
authors.lastname: Roth
authors.forename: Eberhard
authors.initials: E
authors.lastname: Rabe
authors.forename: Sigrid
authors.initials: S
authors.lastname: Karrer
authors.forename: Regina
authors.initials: R
authors.lastname: Renner
authors.forename: Jan
authors.initials: J
authors.lastname: Maschke
authors.forename: Thomas
authors.initials: T
authors.lastname: Horn
authors.forename: Julia
authors.initials: J
authors.lastname: Hepp
authors.forename: Sabine
authors.initials: S
authors.lastname: Eming
authors.forename: Uwe
authors.initials: U
authors.lastname: Wollina
authors.forename: Markus
authors.initials: M
authors.lastname: Zutt
authors.forename: Isabell
authors.initials: I
authors.lastname: Sick
authors.forename: Benno
authors.initials: B
authors.lastname: Splieth
authors.forename: Dorothea
authors.initials: D
authors.lastname: Dill
authors.forename: Joachim
authors.initials: J
authors.lastname: Klode
authors.forename: Joachim
authors.initials: J
authors.lastname: Dissemond
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004700:Endocrine System Diseases / Q000150:complications; D005260:Female; D005858:Germany; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D017511:Pyoderma Gangrenosum / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D055815:Young Adult