Pyoderma gangrenosum requiring inpatient management: A report of 26 cases with follow up

Amanda Saracino, Rob Kelly, Danny Liew, Alvin Heong Chong

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Abstract

We present a case series of inpatients with pyoderma gangrenosum (PG), an ulcerative neutrophilic skin condition of unknown aetiology. Twenty-six patients were admitted with PG, nine men and 17 women. At the time of the chart review, seven patients (26.9%) had died. Patients had a mean of 2.0 active ulcerative lesions and 22 patients' ulcers (84.6%) were on the lower limb. Systemic diseases were coexistent in 15 patients (57.7%), the most common being rheumatoid arthritis (19.2%). Thirty-eight wound cultures were taken and were positive for Staphylococcus aureus in 22 cases (57.8%) and Pseudomonas aeruginosa in 20 (52.6%). After prednisolone, cyclosporin was the next most commonly prescribed systemic therapy (34.6%). Surgical debridement was undertaken in seven cases (26.9%) and two patients had skin grafts. Upon discharge from hospital, 21 patients' ulcers (80.8%) had improved. At 6 months 50% showed complete ulcer healing. Our results highlight the potential severity of PG requiring hospital admission, the need for aggressive therapy and the overall high associated morbidity and mortality.

Original languageEnglish
Pages (from-to)218-221
Number of pages4
JournalAustralasian Journal of Dermatology
Volume52
Issue number3
DOIs
Publication statusPublished - Aug 2011
Externally publishedYes

Keywords

  • leg ulcers
  • neutrophilic dermatosis
  • pyoderma gangrenosum

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