Tricenter analysis of cofactors and comorbidity in patients with pyoderma gangrenosum

Introduction: Pyoderma gangrenosum (PG) is a rare neutrophilic, ulcerative skin disease of largely unknown pathophysiology. Material and methods : In this study, potentially relevant cofactors and comorbidities in patients with PG from three dermatological wound care centers in Germany were evaluated. Results: Of the 121 patients assessed, women (66.9 %) were more frequently affected than men. Patient age ranged from 18 to 96 years (mean 59.8). Wound size varied from 1-600 cm(2) (mean 65.6 cm(2)), and the pain intensity was predominantly very high (VAS 1-10, mean 7). The lower legs were most commonly (71.9 %) affected. Overall, 12 (9.9 %) patients had inflammatory bowel disease (ulcerative colitis, 5.8 %; Crohn's disease, 4.1 %), 14.1 % exhibited rheumatic comorbidities. Neoplasms were found in 20.6 % of patients, with 6.6 % classified as hematological and 14.0 % as solid neoplasms. With respect to criteria for the metabolic syndrome, obesity was found in 69.4 %, arterial hypertension in 57.9 %, and diabetes mellitus in 33.9 % of patients. Conclusions: The present data analysis confirms the association of PG with metabolic syndrome and neoplasms. In the future, these aspects should be included in the targeted diagnostic workup of patients with PG and subsequently treated in a timely fashion.