TY - JOUR
T1 - Poor prognosis of arthritis-associated pyoderma gangrenosum
AU - Charles, Carlos A.
AU - Bialy, Tracy L.
AU - Falabella, Anna F.
AU - Eaglstein, William H.
AU - Kerdel, Francisco A.
AU - Kirsner, Robert S.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2004/7
Y1 - 2004/7
N2 - Background: The association between pyoderma gangrenosum (PG) and arthritis is well established. We have observed a refractory population of patients with arthritis-associated PG (PGA). We, therefore, tested the hypothesis that differences exist in response to treatment in patients with PGA compared with patients with PG without arthritis. Observations: We performed a review of patients with PG during a 2-year period. Patients had noninfectious chronic ulcerations clinically typical for PG, exclusion of relevant differential diagnoses, and consistent histopathological features. Outcomes compared between patients with arthritis (PGA) and without arthritis (PG) included complete healing, percentage change in wound size, and duration of therapy. Of 10 PG ulcers, 7 healed, compared with 2 of 8 PGA ulcers. There was a greater mean percentage decrease in wound size in the PG vs the PGA ulcers (78.9% vs 23.4%; P = .10) and a shorter mean duration of treatment (8.7 vs 14.8 months; P = .18). Conclusions: The ulcers of patients with PGA seem more refractory to treatment than the ulcers of patients with PG alone. Those with PGA ulcers represent a refractory subset of patients, and the ulcers are possibly secondary to unique pathophysiological features.
AB - Background: The association between pyoderma gangrenosum (PG) and arthritis is well established. We have observed a refractory population of patients with arthritis-associated PG (PGA). We, therefore, tested the hypothesis that differences exist in response to treatment in patients with PGA compared with patients with PG without arthritis. Observations: We performed a review of patients with PG during a 2-year period. Patients had noninfectious chronic ulcerations clinically typical for PG, exclusion of relevant differential diagnoses, and consistent histopathological features. Outcomes compared between patients with arthritis (PGA) and without arthritis (PG) included complete healing, percentage change in wound size, and duration of therapy. Of 10 PG ulcers, 7 healed, compared with 2 of 8 PGA ulcers. There was a greater mean percentage decrease in wound size in the PG vs the PGA ulcers (78.9% vs 23.4%; P = .10) and a shorter mean duration of treatment (8.7 vs 14.8 months; P = .18). Conclusions: The ulcers of patients with PGA seem more refractory to treatment than the ulcers of patients with PG alone. Those with PGA ulcers represent a refractory subset of patients, and the ulcers are possibly secondary to unique pathophysiological features.
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U2 - 10.1001/archderm.140.7.861
DO - 10.1001/archderm.140.7.861
M3 - Review article
C2 - 15262699
AN - SCOPUS:3142763291
VL - 140
SP - 861
EP - 864
JO - JAMA Dermatology
JF - JAMA Dermatology
SN - 2168-6068
IS - 7
ER -