title: Pyoderma gangrenosum: clinical characteristics, associated diseases, and responses to treatment in a retrospective cohort study of 31 patients.
abstract: OBJECTIVE
  The aim of this study was to describe the clinical characteristics of patients with pyoderma gangrenosum (PG) and to evaluate the association between these characteristics, the treatment followed, and the patient responses, relapses, and mortality rates.
  
  
  METHODS
  This retrospective cohort study identified adults diagnosed with pyoderma gangrenosum over the duration of 10 years.
  
  
  RESULTS
  Thirty-one patients were evaluated; 58% were women and 55% were older than 65 years, 87% presented with the ulcerative type, and 77% showed lower limb compromise. Approximately 74% of the cases were associated with systemic disease. The most frequent were inflammatory bowel disease (32%) and hematologic malignancies (22%). Pyoderma gangrenosum preceded the associated disease in 26% of the patients, all of them were younger than 50 years old (P = 0.059). In 83% of the latter, the diagnosis of associated disease followed the cutaneous lesions within 24 months. Among the 10 patients with inflammatory bowel disease, six required biologic agents to control the pyoderma gangrenosum (P = 0.002).
  
  
  CONCLUSIONS
  Despite the advances that have been made in the treatment of patients with pyoderma gangrenosum, we are still unclear as to the optimal way in which patients should be followed up once the diagnosis is made. The results of our study underline the importance of doing screening tests to detect potential disease, emphasizing patients younger than 50 years old, for a minimum time lapse of 24 months. It is essential to design randomized-controlled trials to understand the most appropriate and effective ways of following up patients with pyoderma gangrenosum.
authors.affiliation: Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Aldana S
authors.initials: AS
authors.lastname: Vacas
authors.affiliation: Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Ana C
authors.initials: AC
authors.lastname: Torre
authors.affiliation: Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: María L
authors.initials: ML
authors.lastname: Bollea-Garlatti
authors.affiliation: Department of Internal Medicine, Research Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Fernando
authors.initials: F
authors.lastname: Warley
authors.affiliation: Chair of Dermatology, Universidad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Galimberti
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis; D016572:Cyclosporine / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use; D000068800:Etanercept / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D019337:Hematologic Neoplasms / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000175:diagnosis; D000069285:Infliximab / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D017511:Pyoderma Gangrenosum / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate
chemical_list: D003879:Dermatologic Agents; D005938:Glucocorticoids; D016572:Cyclosporine; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept; D011241:Prednisone