Faculty Collaboration Database

Pyoderma gangrenosum demographics, treatments, and outcomes: an analysis of 2,273 cases. J Wound Care 2018 Jan 01;27(Sup1):S4-S8

Date

01/16/2018

Pubmed ID

29334018

DOI

10.12968/jowc.2018.27.Sup1.S4

Scopus ID

2-s2.0-85042510451 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

OBJECTIVE: Pyoderma gangrenosum is a rare, neutrophil-mediated, auto-inflammatory dermatosis. This condition has clinical features analogous to infectious processes and must be quickly diagnosed to be properly treated. The purpose of this study was to characterise relevant clinical features associated with pyoderma gangrenosum based on a large inpatient cohort.

METHOD: The National Inpatient Sample (US) was used to identify patients with the diagnosis of pyoderma gangrenosum using ICD-9 diagnosis code 686.01, during the years 2008-2010. Data was collected on demographics, associated diagnoses, treatments and outcomes. Data analysis was performed using SAS 9.3 software.

RESULTS: A total of 2,273 adult patients were identified with pyoderma gangrenosum. Mean age was 56 years; 66.4% were female; 71.1% were Caucasian. Pyoderma gangrenosum was the primary diagnosis in 22.6% of patients, followed by cellulitis (9.4%), inflammatory bowel disease (IBD) (6.9%), wound/ulcer (5.4%), sepsis (4.7%), and postoperative infection/complication (2.7%). The most common procedures performed were wound debridement (5.3%), skin biopsy (5.1%), esophagogastroduodenoscopy (2%), large bowel biopsy (1.9%), and incision and drainage (1.1%). A total of 74 patients (3.2%) died during hospitalisation.

CONCLUSION: Pyoderma gangrenosum is a serious skin condition, frequently associated with systemic disease, and often confused with other skin pathergies. Pyoderma gangrenosum should be considered when evaluating patients with ulcers, wounds, and post-operative complications. A high index of suspicion is necessary for early and accurate diagnosis and prompt treatment.

Author List

Sasor SE, Soleimani T, Chu MW, Cook JA, Nicksic PJ, Tholpady SS

Author

Sarah E. Sasor MD Associate Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Child
Cohort Studies
Demography
Female
Humans
Inpatients
Male
Middle Aged
Postoperative Complications
Pyoderma Gangrenosum
Sex Factors
United States
Young Adult