Spectrum of diseases associated with pyoderma gangrenosum and correlation with effectiveness of therapy: New insights on the diagnosis and therapy of comorbid hidradenitis suppurativa.

Pyoderma gangrenosum (PG) has been linked to various underlying systemic diseases; many associations are based on case reports or small case series, including hidradenitis suppurativa. Literature examining systemic therapies according to underlying comorbid condition is limited. The study objective...

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Publicado en:Wound Repair & Regeneration Vol. 30; no. 3; pp. 338 - 345
Autores principales: Fischer, Alexander H., Jourabchi, Natanel, Khalifian, Saami, Lazarus, Gerald S.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell May/Jun2022
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Spectrum of diseases associated with pyoderma gangrenosum and correlation with effectiveness of therapy: New insights on the diagnosis and therapy of comorbid hidradenitis suppurativa.
      aug:
        au:
          Fischer, Alexander H.
          Jourabchi, Natanel
          Khalifian, Saami
          Lazarus, Gerald S.
        affil: Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
      sug:
        subj:
          Pyoderma Gangrenosum
          Comorbidity
          Hidradenitis Suppurativa
          Human
          Male
          Female
          Inflammatory Bowel Diseases
          Arthritis, Rheumatoid
          Paraproteinemias
          Male
          Female
      ab: Pyoderma gangrenosum (PG) has been linked to various underlying systemic diseases; many associations are based on case reports or small case series, including hidradenitis suppurativa. Literature examining systemic therapies according to underlying comorbid condition is limited. The study objective was to investigate comorbid diseases of PG and correlate disease associations with effectiveness of therapeutic interventions. Using Johns Hopkins Medical Institutions medical records, 220 patients had an ICD-9 code of 686.01 for PG between 1 January 2006 and 30 June 2015, of whom 130 patients met rigorous inclusion/exclusion criteria for PG (non-peristomal). The 130 PG patients in our study were 69% female, 58% Caucasian, and 35% African American. Documented comorbid conditions included inflammatory bowel disease (IBD; 35%), rheumatoid arthritis (RA; 12%), hidradenitis suppurativa (HS; 14%), and monoclonal gammopathy (12%). PG patients with HS versus without HS were more likely to be African-American (83% vs. 28%; P < 0.001) and had an earlier mean age of PG onset (38 vs. 48 years; P = 0.02). Strikingly, 53% of female African-American patients with PG onset prior to age 40 had comorbid HS. Comorbid inflammatory bowel disease was observed in 38% of PG patients with RA, 28% of PG patients with HS, and 27% of PG patients with monoclonal gammopathy. Of the 32 patients who received infliximab for active PG, complete ulcer healing was observed in 83% (5/6) of patients with comorbid HS versus 31% (8/26) of patients without HS (Fisher exact P = 0.03). Screening patients for associated systemic disease for multiple related illnesses is essential. Effectiveness of systemic therapy may depend upon the underlying systemic disease; hidradenitis suppurativa may be a specific example.
      pubtype: Academic Journal
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    language: English
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