Perioperative management of pyoderma gangrenosum

Carter K. Haag, Lindsay Bacik, Emile Latour, Daniel C. Morse, Nicole M. Fett, Alex G. Ortega-Loayza

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Pyoderma gangrenosum (PG) classically presents with an acute inflammatory stage, characterized by rapid evolution of painful ulcerations. The pathergy associated with PG lesions complicates disease management. Although PG is commonly treated with immunosuppression, some patients have refractory noninflammatory ulcers. In this subpopulation, there are case reports of successful surgical treatment. However, there is no consensus on optimal perioperative treatment for patients with PG undergoing surgery of any kind, PG related or otherwise. Therefore, we conducted a comprehensive literature review describing perioperative management practices and risk factors that may predict response to surgical intervention. We identified 126 cases of surgical intervention in patients with active PG; among these, only 16.7% experienced postoperative disease progression. No perioperative treatments or clinical risk factors were identified as statistically significant predictors of disease recurrence. Although limited by case series design and publication bias, this study is a valuable means of hypothesis generation for this rare condition.

Original languageEnglish (US)
Pages (from-to)369-374
Number of pages6
JournalJournal of the American Academy of Dermatology
Volume83
Issue number2
DOIs
StatePublished - Aug 2020

Keywords

  • immunosuppressants
  • perioperative management
  • postoperative treatment
  • prophylaxis
  • pyoderma gangrenosum
  • surgery

ASJC Scopus subject areas

  • Dermatology

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