Pyoderma gangrenosum. A comparison of typical and atypical forms with an emphasis on time to remission. Case review of 86 patients from 2 institutions.
Pyoderma gangrenosum (PG) is an idiopathic, inflammatory, ulcerative disease of undetermined cause. The diagnosis is based on clinical and pathologic features and requires exclusion of conditions that produce ulcerations. An atypical bullous variant (atypical pyoderma gangrenosum, APG) exists with c...
| Published in: | Medicine Vol. 79; no. 1; pp. 37 - 47 |
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| Main Authors: | , , , , , , |
| Format: | research Journal Article |
| Published: |
Lippincott Williams & Wilkins
2000 Jan
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104719530&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104719530 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00257974 2S6 jtl: Medicine issn: 00257974 maglogo: N pubinfo: dt: 2000 Jan vid: 79 iid: 1 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 104719530 104719530 NLM10670408 2011077199 10.1097/00005792-200001000-00004 NLM10670408 104719530 ppf: 37 ppct: 10 formats: tig: atl: Pyoderma gangrenosum. A comparison of typical and atypical forms with an emphasis on time to remission. Case review of 86 patients from 2 institutions. aug: au: Bennett, M L Jackson, J M Jorizzo, J L Fleischer Jr, A B White, W L Callen, J P Fleischer, A B Jr affil: Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. sug: subj: Pyoderma Gangrenosum Diagnosis Adolescence Adult Aged Aged, 80 and Over Child Child, Preschool Diagnosis, Differential Female Human Male Middle Age Pyoderma Gangrenosum Drug Therapy Pyoderma Gangrenosum Pathology Disease Remission Retrospective Design Time Factors Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Aged, 80 & over Child: 6-12 years Child, Preschool: 2-5 years Middle Aged: 45-64 years Female Male ab: Pyoderma gangrenosum (PG) is an idiopathic, inflammatory, ulcerative disease of undetermined cause. The diagnosis is based on clinical and pathologic features and requires exclusion of conditions that produce ulcerations. An atypical bullous variant (atypical pyoderma gangrenosum, APG) exists with clinical features similar to those of Sweet syndrome. Because PG is a rare disease, few large case series have been reported. Pyoderma gangrenosum was first recognized as a unique disease entity in the first half of the 20th century. Cumulative knowledge of PG is based on a handful of case series and multiple individual case reports. To augment that knowledge, we present our experience with a large number of patients over a significant time. We performed a retrospective analysis of the medical records of 86 patients with PG who were evaluated and treated over 12 years at 2 university-based dermatology departments. The mean (+/- standard deviation) age of onset of PG and APG, respectively, was 44.6 +/- 19.7 years and 52.2 +/- 15.3 years. Lower extremity involvement was most common in PG, whereas upper extremity involvement was most common in APG. Associated relevant systemic diseases were seen in 50% of patients. Inflammatory bowel disease was the most common association in patients with PG, whereas hematologic disease or malignancy was most common in those with APG. Although a few patients were managed with local measures or nonimmunosuppressive treatment, the majority required oral corticosteroid therapy, often with systemic immunosuppressive treatment. PG patients required a mean 11.5 +/- 11.1 months of treatment to achieve remission compared with 9.0 +/- 13.7 months for patients with APG. Five patients (5.8%) had disease that was extremely refractory to multiple intensive therapies. The prognosis and disease associations for PG and APG appear to be different. Compared with PG, APG is more often associated with hematologic disease or malignancy, and remits more quickly. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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