title: Pediatric Pyoderma Gangrenosum: A Retrospective Review of Clinical Features, Etiologic Associations, and Treatment.
abstract: OBJECTIVE
  Pyoderma gangrenosum (PG) is a neutrophilic dermatosis rarely seen in children. Its features have not been well characterized in children. We sought to characterize the clinical features, etiologic associations, and treatment of PG in children younger than 18 years.
  
  
  METHODS
  We performed a retrospective review of children younger than 18 years with PG at the Mayo Clinic from January 1976 to August 2013.
  
  
  RESULTS
  Thirteen children with PG were identified (n = 8; 62% female). All had ulcerations, with 62% having pustular lesions. Sites of involvement included the trunk (77%), lower extremities (77%), upper extremities (38%), and head and neck (38%). Nine (69%) had an underlying comorbidity, including seven with Crohn's disease (54%), one with juvenile idiopathic arthritis (8%), and one with pyogenic arthritis, pyoderma gangrenosum, and acne syndrome (8%). Treatments included topical or local care (92%) and systemic therapies (85%) such as oral corticosteroids (62%) and sulfasalazine or related 5-aminosalicylate drugs (46%). The clinical course did not correlate with that of the underlying systemic disease and response to treatment varied.
  
  
  CONCLUSIONS
  Pediatric PG has a more varied anatomic distribution and a greater predominance of pustular lesions than PG in adults and a strong association with inflammatory bowel disease.
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Schoch
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Stanislav N
authors.initials: SN
authors.lastname: Tolkachjov
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Cappel
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.|Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Gibson
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Dawn Marie R
authors.initials: DM
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D017511:Pyoderma Gangrenosum / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D012189:Retrospective Studies; D012460:Sulfasalazine / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D012460:Sulfasalazine; D019804:Mesalamine