Pyoderma Gangrenosum: Retrospective Evaluation of Clinical Features and Treatment Responses in 23 Cases

Abstract

Pyoderma gangrenosum (PG) is a rare inflammatory disease in the spectrum of
neutrophilic diseases characterized by rapidly progressive, painful and large ulcers. In
this study, we aimed to investigate the relationship between the clinical characteristics
and treatment responses of patients diagnosed with PG, treated and followed up in our
clinic. Between 2018 and 2023, 23 patients diagnosed with PG in our clinic were
included in the study. Medical file records were retrospectively analyzed and various
demographic and clinical characteristics, comorbid systemic diseases, treatment
protocols and treatment responses of the patients were recorded. Twelve (52.2%) of the
patients were female and 11 (47.8%) were male, with a mean age of 42.4±12.9 years.
The median disease duration was 52 months (range: 10-540 months). Systemic diseases
accompanying PG were present in 14 patients (60.9%). Systemic steroids were the
most common treatment (43.5%). Other treatment approaches included adalimumab,
infliximab, cyclosporine, oral doxycycline, topical tacrolimus, topical corticosteroids
and intralesional steroids. Remission was achieved in 14 patients (60.9%), relapse was
observed in 5 patients (21.74%), and no remission/relapse information was available for
4 patients (17.4%) who lost follow-up. The median duration of remission was 23
months (range: 3-96 months). Although systemic steroids are most commonly used in
the treatment of pyoderma gangrenosum, it should be kept in mind that there are various
treatment options ranging from systemic and topical anti-inflammatory therapies to
biologic agents according to close follow-up of the patients and additional systemic
diseases.