Ocular pyoderma gangrenosum: A systematic review.
BACKGROUND
Pyoderma gangrenosum (PG) is a rare, ulcerative cutaneous disorder. Ophthalmic involvement in PG is atypical, but can have devastating consequences.


OBJECTIVE
We sought to characterize ocular PG to allow for earlier diagnosis and therapy. To our knowledge, this is the first systematic review summarizing this clinical variant.


METHODS
A systematic review was conducted using PubMed and Web of Science. Data were extracted and studies were qualitatively assessed and analyzed.


RESULTS
We identified all 34 cases of PG involving the eye and periorbital area, and categorized them into 4 different subtypes. Common presenting signs include ulceration, peripheral ulcerative keratitis, and decreased visual acuity. Although it is often difficult to biopsy ocular PG, histologic features are nonspecific. Combined therapy using corticosteroids and further surgical reconstruction as needed is the mainstay of treatment. Cases of the eye/orbit in particular should be treated aggressively, as these are more likely to relapse compared with cases of the periorbital area.


CONCLUSIONS
Use of case reports, paucity of ocular PG cases, and heterogeneity of studies are limitations.


CONCLUSIONS
PG should be considered in the differential diagnosis of ulceration of ocular/periocular tissues. An aggressive, early, multimodal treatment strategy should be used to prevent relapse, especially in cases of the eye/orbit.
School of Medicine, Virginia Commonwealth University, Richmond, Virginia.
Angela S
AS
Gupta
Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon. Electronic address: ortegalo@ohsu.edu.
Alex G
AG
Ortega-Loayza
D015897:Comorbidity; D003937:Diagnosis, Differential; D005128:Eye Diseases / Q000145:classification / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D017511:Pyoderma Gangrenosum / Q000145:classification / Q000175:diagnosis* / Q000628:therapy*
extracutaneous; eye; inflammation; neutrophilic dermatoses; ocular; periorbital; pyoderma gangrenosum