Risk of developing pyoderma gangrenosum after procedures in patients with a known history of pyoderma gangrenosum-A retrospective analysis.

Background: The risk of postoperative pyoderma gangrenosum (PG) in patients with a known history of PG is unknown.Objective: To quantify risk and identify patient- and/or procedure-related risk factors for postsurgical recurrence or exacerbation of PG in patients with a known history of PG.Methods:...

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Publicado en:Journal of the American Academy of Dermatology Vol. 78; no. 2; pp. 310 - 311
Autores principales: Xia, Fan Di, Liu, Kristina, Lockwood, Stephen, Butler, Daniel, Tsiaras, William G., Joyce, Cara, Mostaghimi, Arash
Formato: research Journal Article
Publicado: Elsevier B.V. Feb2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2018
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      pub: Elsevier B.V.
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        atl: Risk of developing pyoderma gangrenosum after procedures in patients with a known history of pyoderma gangrenosum-A retrospective analysis.
      aug:
        au:
          Xia, Fan Di
          Liu, Kristina
          Lockwood, Stephen
          Butler, Daniel
          Tsiaras, William G.
          Joyce, Cara
          Mostaghimi, Arash
        affil: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
      sug:
        subj:
          Pyoderma Gangrenosum Epidemiology
          Postoperative Complications Epidemiology
          Surgery, Operative Statistics and Numerical Data
          Odds Ratio
          Female
          Retrospective Design
          Massachusetts
          Middle Age
          Disease Progression
          Biopsy Statistics and Numerical Data
          Risk Factors
          Microsurgery Statistics and Numerical Data
          Male
          Recurrence
          Human
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: The risk of postoperative pyoderma gangrenosum (PG) in patients with a known history of PG is unknown.Objective: To quantify risk and identify patient- and/or procedure-related risk factors for postsurgical recurrence or exacerbation of PG in patients with a known history of PG.Methods: We retrospectively evaluated the likelihood of postsurgical recurrence or exacerbation of PG for all patients with a confirmed diagnosis of PG at Brigham and Women's Hospital and Massachusetts General Hospital from 2000 to 2015.Results: In all, 5.5% of procedures (n = 33) led to recurrence of PG in 15.1% of patients (n = 25). Compared with skin biopsy, small open surgical procedures had an adjusted odds ratio (aOR) of 8.65 (95% confidence interval [CI], 1.55-48.33) for PG recurrence or exacerbation; large open surgical procedures had an aOR of 5.97 (95% CI, 1.70-21.00); and Mohs micrographic surgery/skin excision had an aOR of 6.47 (95% CI, 1.77-23.61). PG chronically present at the time of the procedure had an aOR of 4.58 (95% CI, 1.72-12.22). Immunosuppression, time elapsed since the original PG diagnosis, and procedure location did not significantly influence risk.Limitations: Our study is limited by its retrospective nature and relatively small sample size.Conclusion: There is a small but clinically meaningful risk for postsurgical recurrence or exacerbation of PG in patients with a known history of PG; higher risks occur with more invasive procedures and chronically present PG.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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