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


Authors: Xia, F. D.; Liu, K; Lockwood, S.; Butler, D.; Tsiaras, W. G.; Joyce, C; Mostaghimi, A
Article Title: Risk of developing pyoderma gangrenosum after procedures in patients with a known history of pyoderma gangrenosum-A retrospective analysis
Abstract: 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#39;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.
Keywords: Risk Factors; Recurrence; postoperative; Pyoderma Gangrenosum; prophylaxis; Clinical and Experimental Research; exacerbation; pathergy
Journal Title: Journal of the American Academy of Dermatology
Volume: 78
Issue: 2
ISSN: 1097-6787; 0190-9622
Publisher: American Academy of Dermatology, Inc. Published by Elsevier Inc  
Journal Place: United States
Date Published: 2018
Start Page: 310
End Page: 314.e1
Language: eng
DOI/URL:
Notes: LR: 20180115; CI: Copyright (c) 2017; JID: 7907132; OTO: NOTNLM; 2017/08/16 00:00 [received]; 2017/09/11 00:00 [revised]; 2017/09/16 00:00 [accepted]; 2017/09/28 06:00 [pubmed]; 2017/09/28 06:00 [medline]; 2017/09/27 06:00 [entrez]; ppublish