Pyoderma gangrenosum: A retrospective study of 25 cases and review of the literature findings

Objective: Pyoderma gangrenosum is a rare inflammatory disease of unknown etiology characterized by neutrophilic infitration. Our aim was to evaluate the demographic and clinical features of patients with pyoderma gangrenosum and to review the literature findings about pyoderma gangrenosum. Material and Methods: Patients diagnosed with pyoderma gangrenosum between 1980-2009 years were retrospectively evaluated. Response was determined as complete improvement of the lesion with therapy. Results: The study included 25 patients (15 female, 10 male) with a mean age of 42 years. Mean disease duration was 2.7 years. The most common variant (84%) was ulcerative variant. 6 patients (24%) had a history of trauma that preceded the onset of lesions, and 10 patients (40%) had recurrent attacks. Multiple lesions (≥2) were observed in 12 patients (48%). Inflammatory bowel disease was present in 4 patients (16%). Other associated diseases included acute myeloid leukemia, vasculitis, aganglionic megacolon, incomplete Behçet's disease, and Takayasu arteritis and diabetes mellitus. The most common lesion localization was the lower extremities (72%). Majority (88%) of the patients were treated with systemic immunosu-pressive agents, the most common immunsupressive agent used was systemic corticosteroids (n=18, 72%), and of those 88.8% (n=16) responded to the treatment. Conclusion: Pyoderma gangrenosum was primarily seen in adults with a slight female predominance, had a predilection for the lower extremities and ulcerative variant was the most common clinical type. Forty-four percent of patients had associated systemic disease of which the inflammatory bowel disease was the most common. Systemic corticosteroids were the mainstay of systemic therapy.