Digestive Diseases and Sciences

, Volume 58, Issue 10, pp 2949–2954

Characteristics and Treatment of Pyoderma Gangrenosum in Inflammatory Bowel Disease

  • F. Argüelles-Arias
  • L. Castro-Laria
  • T. Lobatón
  • M. Aguas-Peris
  • M. Rojas-Feria
  • M. Barreiro-de Acosta
  • P. Soto-Escribano
  • M. Calvo-Moya
  • D. Ginard-Vicens
  • M. Chaparro-Sánchez
  • M. Hernández-Durán
  • B. Castro-Senosiain
  • A. Fernández-Villaverde
  • V. García-Sánchez
  • E. Domínguez-Muñoz
  • A. Caunedo-Álvarez
  • J. M. Herrerías-Gutiérrez
Original Article

DOI: 10.1007/s10620-013-2762-2

Cite this article as:
Argüelles-Arias, F., Castro-Laria, L., Lobatón, T. et al. Dig Dis Sci (2013) 58: 2949. doi:10.1007/s10620-013-2762-2

Abstract

Background

Pyoderma gangrenosum is a serious cutaneous complication seen in approximately 1 % of patients with inflammatory bowel disease (IBD). Oral corticosteroids are the mainstay treatment, although the evidence supporting their use is weak.

Aims

The purpose of this study was to investigate the characteristics of pyoderma gangrenosum associated with Crohn’s disease or ulcerative colitis and which treatments are prescribed in Spanish clinical practice.

Methods

In this retrospective, observational study, the medical records from all patients with IBD and a diagnosis of pyoderma gangrenosum attended by the gastroenterology departments of 12 Spanish hospitals were reviewed. Data on patient demographics and characteristics, underlying IBD and treatment, and pyoderma gangrenosum characteristics, treatment, and outcome were collected and analyzed.

Results

The data from 67 patients were analyzed (41 [61.2 %] women, 41 [61.2 %] with Crohn’s disease, 25 [37.3 %] with ulcerative colitis, and 1 [1.5 %] with indeterminate disease). The underlying disease was in remission in approximately one-third of patients at the time of presentation of pyoderma gangrenosum. Healing was achieved in all patients (in 3 without any systemic therapy). Oral corticosteroids were taken by 51 patients (76.1 %), almost always as first-line treatment, although definitive healing was attained in 19 (28.4 %). Biologic agents such as infliximab and adalimumab were taken by 31 patients (46.3 %) at some point (first-line in 6 patients [9.0 %]), with definitive healing in 29 patients (93.5 %).

Conclusions

Oral corticosteroid therapy remains the most common treatment for pyoderma gangrenosum associated with inflammatory bowel disease. Biologic therapies such as infliximab and adalimumab should also be considered.

Keywords:

Pyoderma gangrenosum Crohn’s disease Ulcerative colitis Biologic agents Treatment Epidemiology 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • F. Argüelles-Arias
    • 1
  • L. Castro-Laria
    • 1
  • T. Lobatón
    • 2
  • M. Aguas-Peris
    • 3
  • M. Rojas-Feria
    • 4
  • M. Barreiro-de Acosta
    • 5
  • P. Soto-Escribano
    • 6
  • M. Calvo-Moya
    • 7
  • D. Ginard-Vicens
    • 8
  • M. Chaparro-Sánchez
    • 9
    • 10
  • M. Hernández-Durán
    • 11
  • B. Castro-Senosiain
    • 12
  • A. Fernández-Villaverde
    • 13
  • V. García-Sánchez
    • 6
  • E. Domínguez-Muñoz
    • 5
  • A. Caunedo-Álvarez
    • 1
  • J. M. Herrerías-Gutiérrez
    • 1
  1. 1.Hospital Virgen MacarenaSevilleSpain
  2. 2.Hospital de BellvitgeHospitalet de LlobregatSpain
  3. 3.Hospital La FeValenciaSpain
  4. 4.Hospital de ValmeSevilleSpain
  5. 5.Hospital Santiago de CompostelaSantiagoSpain
  6. 6.Hospital Reina SofíaCórdobaSpain
  7. 7.Hospital Clínica Puerta de HierroMadridSpain
  8. 8.Hospital Son EspasesPalmaSpain
  9. 9.Hospital De La PrincesaMadridSpain
  10. 10.Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)MadridSpain
  11. 11.Hospital Virgen del PuertoPlasenciaSpain
  12. 12.Hospital Marqués de ValdecillaSantanderSpain
  13. 13.Hospital de PovisaVigoSpain

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