Characteristics and treatment of pyoderma gangrenosum in inflammatory bowel disease.

Background: Pyoderma gangrenosum is a serious cutaneous complication seen in approximately 1 % of patients with inflammatory bowel disease (IBD). Oral corticosteroids are the mainstay treatment, although the evidence supporting their use is weak.Aims: The purpose of this study was to investigate the...

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Publicado en:Digestive Diseases & Sciences Vol. 58; no. 10; pp. 2949 - 2955
Autores principales: Argüelles-Arias, F, Castro-Laria, L, Lobatón, T, Aguas-Peris, M, Rojas-Feria, M, Barreiro-de Acosta, M, Soto-Escribano, P, Calvo-Moya, M, Ginard-Vicens, D, Chaparro-Sánchez, M, Hernández-Durán, M, Castro-Senosiain, B, Fernández-Villaverde, A, García-Sánchez, V, Domínguez-Muñoz, E, Caunedo-Alvarez, A, Herrerías-Gutiérrez, J M, Caunedo-Álvarez, A
Formato: research Journal Article
Publicado: Springer Nature Oct2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2013
      vid: 58
      iid: 10
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      pub: Springer Nature
      place: New York, New York
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        NLM23828140
        2012308588
        10.1007/s10620-013-2762-2
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        atl: Characteristics and treatment of pyoderma gangrenosum in inflammatory bowel disease.
      aug:
        au:
          Argüelles-Arias, F
          Castro-Laria, L
          Lobatón, T
          Aguas-Peris, M
          Rojas-Feria, M
          Barreiro-de Acosta, M
          Soto-Escribano, P
          Calvo-Moya, M
          Ginard-Vicens, D
          Chaparro-Sánchez, M
          Hernández-Durán, M
          Castro-Senosiain, B
          Fernández-Villaverde, A
          García-Sánchez, V
          Domínguez-Muñoz, E
          Caunedo-Alvarez, A
          Herrerías-Gutiérrez, J M
          Caunedo-Álvarez, A
        affil: Hospital Virgen Macarena, Dr. Fedriani s/n, 41071, Seville, Spain, farguelles@telefonica.net.
      sug:
        subj:
          Colitis, Ulcerative Complications
          Crohn Disease Complications
          Inflammatory Bowel Diseases Complications
          Pyoderma Gangrenosum Drug Therapy
          Pyoderma Gangrenosum Pathology
          Administration, Oral
          Administration, Topical
          Adrenal Cortex Hormones Administration and Dosage
          Adrenal Cortex Hormones Therapeutic Use
          Adult
          Antibodies, Monoclonal Administration and Dosage
          Antibodies, Monoclonal Therapeutic Use
          Female
          Human
          Male
          Middle Age
          Pyoderma Gangrenosum Etiology
          Retrospective Design
          Spain
          Treatment Outcomes
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Pyoderma gangrenosum is a serious cutaneous complication seen in approximately 1 % of patients with inflammatory bowel disease (IBD). Oral corticosteroids are the mainstay treatment, although the evidence supporting their use is weak.Aims: The purpose of this study was to investigate the characteristics of pyoderma gangrenosum associated with Crohn's disease or ulcerative colitis and which treatments are prescribed in Spanish clinical practice.Methods: In this retrospective, observational study, the medical records from all patients with IBD and a diagnosis of pyoderma gangrenosum attended by the gastroenterology departments of 12 Spanish hospitals were reviewed. Data on patient demographics and characteristics, underlying IBD and treatment, and pyoderma gangrenosum characteristics, treatment, and outcome were collected and analyzed.Results: The data from 67 patients were analyzed (41 [61.2 %] women, 41 [61.2 %] with Crohn's disease, 25 [37.3 %] with ulcerative colitis, and 1 [1.5 %] with indeterminate disease). The underlying disease was in remission in approximately one-third of patients at the time of presentation of pyoderma gangrenosum. Healing was achieved in all patients (in 3 without any systemic therapy). Oral corticosteroids were taken by 51 patients (76.1 %), almost always as first-line treatment, although definitive healing was attained in 19 (28.4 %). Biologic agents such as infliximab and adalimumab were taken by 31 patients (46.3 %) at some point (first-line in 6 patients [9.0 %]), with definitive healing in 29 patients (93.5 %).Conclusions: Oral corticosteroid therapy remains the most common treatment for pyoderma gangrenosum associated with inflammatory bowel disease. Biologic therapies such as infliximab and adalimumab should also be considered.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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