Clinical and histological patterns and treatment of pyoderma gangrenosum

Pan Afr Med J. 2020 Jun 2:36:59. doi: 10.11604/pamj.2020.36.59.12329. eCollection 2020.

Abstract

Pyoderma gangrenosum (PG) is a rare inflammatory neutrophilic dermatosis for which accurate epidemiological data are limited and therapy remains a challenge. The primary study's aim was to examine all cases of PG observed in our department over a 6-year period in order to describe the relevant characteristics and outcome under therapy. Fourteen patients were included (5 women, 9 men). The average age of our patients was 40,15 years. The classical, ulcerative form was found in 10 cases (71.42%), the pustular form in 4 cases (27.57%) and PG was multifocal in 4 cases. The PG was located preferentially to the lower limbs. Histological examination was realized in all patients and objectified inflammatory infiltrate composed of polymorphonuclear neutrophils in all cases with vasculitis in 4 cases. Six patients (42.85%) had associated disease at diagnosis of PG, including inflammatory bowel disease in two cases (14.28%), a blood disease in 2 cases (14.28%), lymph node tuberculosis and inflammatory arthritis in 1 case (7%). The most frequent first-line treatments were oral corticosteroids (7 cases) and other treatments used were colchicine in 2 cases, topical corticosteroids in 3 cases with good clinical evolution. Our study confirms that PG is a rare disease, associated in almost half of cases with systemic disease already present at diagnosis; in our Moroccan background, it is most often inflammatory bowel disease, hematological or solid cancer and tuberculosis.

Keywords: Pyoderma gangrenosum; neutrophilic dermatosis; systemic disease.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage*
  • Adult
  • Aged
  • Child
  • Colchicine / administration & dosage*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Pyoderma Gangrenosum / drug therapy
  • Pyoderma Gangrenosum / physiopathology*
  • Treatment Outcome
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Colchicine