Associated factors and comorbidities in patients with pyoderma gangrenosum in Germany: a retrospective multicentric analysis in 259 patients
详细信息 查看全文
- 作者：Philipp Al Ghazal (1)
Katharina Herberger (2)
J?rg Schaller (3)
Anke Str?lin (4)
Norman-Philipp Hoff (5)
Tobias Goerge (6)
Hannelore Roth (7)
Eberhard Rabe (8)
Sigrid Karrer (9)
Regina Renner (10)
Jan Maschke (11)
Thomas Horn (12)
Julia Hepp (13)
Sabine Eming (14)
Uwe Wollina (15)
Markus Zutt (16)
Isabell Sick (17)
Benno Splieth (18)
Dorothea Dill (19)
Joachim Klode (20)
Joachim Dissemond (20) - 关键词：Pyoderma gangrenosum ; Chronic ulcer ; Comorbidities ; Metabolic syndrome ; Diabetes mellitus
- 刊名：Orphanet Journal of Rare Diseases
- 出版年：2013
- 出版时间：December 2013
- 年：2013
- 卷：8
- 期：1
- 全文大小：249KB
- 参考文献：1. von den Driesch P: Pyoderma gangrenosum: a report of 44 cases with follow up. / Br J Dermatol 1997,137(6):1000-005. j.1365-2133.1997.20022083.x">CrossRef
2. Powell F, Schroeter A, Su W, Perry H: Pyoderma gangrenosum: a review of 86 patients. / Q J Med 1985, 55:173-86.
3. Bennett M, Jackson J, Jorizzo J, Fleischer A, White W, Callen J: Pyoderma gangrenosum. A comparison of typical and atypical forms with an emphasis on time to remission. Case review of 86 patients from 2 institutions. / Medicine (Baltimore) 2000,79(1):37-6. CrossRef
4. Marzano AV, Ishak RS, Saibeni S, Crosti C, Meroni PL, Cugno M: Autoinflammatory skin disorders in inflammatory bowel diseases, pyoderma gangrenosum and sweet’s syndrome: a comprehensive review and disease classification criteria. / Clin Rev Allergy Immunol in press
5. Marzano AV, Cugno M, Trevisan V, Fanoni D, Venegoni L, Berti E, Crosti C: Role of inflammatory cells, cytokines and matrix metalloproteinases in neutrophil-mediated skin diseases. / Clin Exp Immunol 2010,162(1):100-07. j.1365-2249.2010.04201.x">CrossRef
6. Langan SM, Groves RW, Card TR, Gulliford MC: Incidence, mortality, and disease associations of pyoderma gangrenosum in the United Kingdom: a retrospective cohort study. / J Invest Dermatol 2012,132(9):2166-170. jid.2012.130">CrossRef
7. Brooklyn TN, Williams AM, Dunnill MG, Probert CS: T-cell receptor repertoire in pyoderma gangrenosum: evidence for clonal expansions and trafficking. / Br J Dermatol 2007,157(5):960-66. j.1365-2133.2007.08211.x">CrossRef
8. Adachi Y, Kindzelskii AL, Cookingham G, Shaya S, Moore EC, Todd RF, Petty HR: Aberrant neutrophil trafficking and metabolic oscillations in severe pyoderma gangrenosum. / J Invest Dermatol 1998,111(2):259-68. j.1523-1747.1998.00311.x">CrossRef
9. Kawakami T, Yamazaki M, Soma Y: Reduction of interleukin-6, interleukin-8, and anti-phosphatidylserine-prothrombin complex antibody by granulocyte and monocyte adsorption apheresis in a patient with pyoderma gangrenosum and ulcerative colitis. / Am J Gastroenterol 2009,104(9):2363-364. jg.2009.271">CrossRef
10. Wollina U: Pyoderma gangrenosum - a review. / Orphanet J Rare Dis 2007, 2:19. CrossRef
11. Cortesio CL, Wernimont SA, Kastner DL, Cooper KM, Huttenlocher A: Impaired podosome formation and invasive migration of macrophages from patients with a PSTPIP1 mutation and PAPA syndrome. / Arthritis Rheum 2010, 62:2556-558. CrossRef
12. Smith EJ, Allantaz F, Bennett L, Zhang D, Gao X, Wood G, Kastner DL, Punaro M, Aksentijevich I, Pascual V, Wise CA: Clinical, molecular, and genetic characteristics of PAPA syndrome: a review. / Curr Genomics 2010,11(7):519-27. CrossRef
13. Brenner M, Ruzicka T, Plewig G, Thomas P, Herzer P: Targeted treatment of pyoderma gangrenosum in PAPA (pyogenic arthritis, pyoderma gangrenosum and acne) syndrome with the recombinant human interleukin-1 receptor antagonist anakinra. / Br J Dermatol 2009,161(5):1199-201. j.1365-2133.2009.09404.x">CrossRef
14. Demidowich AP, Freeman AF, Kuhns DB, Aksentijevich I, Gallin JI, Turner ML, Kastner DL, Holland SM: Brief report: genotype, phenotype, and clinical course in five patients with PAPA syndrome (pyogenic sterile arthritis, pyoderma gangrenosum, and acne). / Arthritis Rheum 2012,64(6):2022-027. CrossRef
15. Braun-Falco M, Kovnerystyy O, Lohse P, Ruzicka T: Pyoderma gangrenosum, acne, and suppurative hidradenitis (PASH) - a new autoinflammatory syndrome distinct from PAPA syndrome. / J Am Acad Dermatol 2012,66(3):409-15. j.jaad.2010.12.025">CrossRef
16. Marzano AV, Ishak RS, Colombo A, Caroli F, Crosti C: Pyoderma gangrenosum, acne and suppurative hidradenitis syndrome following bowel bypass surgery. / Dermatology 2012,225(3):215-19. CrossRef
17. Marzano AV, Trevisan V, Gattorno M, Ceccherini I, De Simone C, Crosti C: Pyogenic arthritis, pyoderma gangrenosum, acne, and hidradenitis suppurativa (PAPASH): a new autoinflammatory syndrome associated with a novel mutation of the PSTPIP1 gene. / JAMA Dermatol 2013,149(6):762-64. jamadermatol.2013.2907">CrossRef
18. Binus AM, Qureshi AA, Li VW, Winterfield LS: Pyoderma gangrenosum: a retrospective review of patient characteristics, comorbidities, and therapy in 103 patients. / Br J Dermatol 2011,165(6):1244-250. j.1365-2133.2011.10565.x">CrossRef
19. Al Ghazal P, K?rber A, Klode J, Dissemond J: Investigation of new-cofactors in 49 patients with pyoderma gangrenosum. / J Dtsch Dermatol Ges 2012,10(4):251-57.
20. Callen J: Pyoderma gangrenosum. / Lancet 1998, 351:581-85. CrossRef
21. Powell F, Su W, Perry H: Pyoderma gangrenosum: classification and management. / J Am Acad Dermatol 1996, 34:395-09. CrossRef
22. Su WP, Davis MD, Weenig RH, Powell FC, Perry HO: Pyoderma gangrenosum: clinicopathologic correlation and proposed diagnostic criteria. / Int J Dermatol 2004,43(11):790-00. j.1365-4632.2004.02128.x">CrossRef
23. Hadi A, Lebwohl M: Clinical features of pyoderma gangrenosum and current diagnostic trends. / J Am Acad Dermatol 2011,64(5):950-54. j.jaad.2010.01.049">CrossRef
24. Wolff K, Stingl G: Pyoderma gangrenosum. In / Fitzpatrick’s Dermatology in general medicine. 5th edition. Edited by: Freedberg IM, Eisen AZ, Wolff K. New York: Mc Graw-Hill; 1999:2207-213.
25. Müller-Ladner U, Alten R, Heiligenhaus A, Kekow J, Koletzko S, Mrowietz U, Ochsenkühn T, Radke M, Reich K, Rudwaleit M, Schreiber S: “TRECID- TNFalpha related chronic inflammatory diseases - a new multiple diseases bridging concept. / Dtsch Med Wochenschr 2009,134(42):2132-136. CrossRef
26. Ko CB, Walton S, Wyatt EH: Pyoderma gangrenosum: associations revisited. / Int J Dermatol 1992, 31:574-77. j.1365-4362.1992.tb02723.x">CrossRef
27. Hurwitz RM, Haseman JH: The evolution of pyoderma gangrenosum: a clinicopathologic correlation. / Am J Dermatopathol 1993, 15:28-3. CrossRef
28. Marzano AV, Trevisan V, Lazzari R, Crosti C: Pyoderma gangrenosum: study of 21 patients and proposal of a ‘clinicotherapeutic-classification. / J Dermatolog Treat 2011,22(5):254-60. CrossRef
29. Bolognia J, Jorizzo J, Rapini R: Pyoderma gangrenosum. / Dermatology 2003, 1:415-18.
30. Davidovici B, Sattar N, Prinz J, Puig L, Emery P, Barker JN, van de Kerkhof P, Stahle M, Nestle FO, Girolomonis G, Krieger JG: Psoriasis and systemic inflammatory diseases: potential mechanistic links between skin disease and co-morbid conditions. / J Invest Dermatol 2010,130(7):1785-796. jid.2010.103">CrossRef
31. Poeggeler B, Schulz C, Pappolla M: Leptin and the skin: a new frontier. / Exp Dermatol 2010,19(1):12-8. j.1600-0625.2009.00930.x">CrossRef - 作者单位：Philipp Al Ghazal (1)
Katharina Herberger (2)
J?rg Schaller (3)
Anke Str?lin (4)
Norman-Philipp Hoff (5)
Tobias Goerge (6)
Hannelore Roth (7)
Eberhard Rabe (8)
Sigrid Karrer (9)
Regina Renner (10)
Jan Maschke (11)
Thomas Horn (12)
Julia Hepp (13)
Sabine Eming (14)
Uwe Wollina (15)
Markus Zutt (16)
Isabell Sick (17)
Benno Splieth (18)
Dorothea Dill (19)
Joachim Klode (20)
Joachim Dissemond (20)
1. Department of Dermatology and Allergy, Skin Cancer Center Hannover, Hannover Medical School, Hannover, Germany
2. Institute for Health Services Research in Dermatology and Nursing, University of Hamburg, Hamburg, Germany
3. Department of Dermatology, St. Barbara Clinics, Duisburg, Germany
4. Department of Dermatology, University of Tuebingen, Tuebingen, Germany
5. Department of Dermatology, Heinrich Heine University, Duesseldorf, Germany
6. Department of Dermatology, University of Muenster, Muenster, Germany
7. Praxis für Venen- und Hauterkrankungen, Jena, Germany
8. Department of Dermatology, University of Bonn, Bonn, Germany
9. Department of Dermatology, Regensburg University Hospital, Regensburg, Germany
10. Department of Dermatology, Venereology and Allergology, University Hospital of Leipzig, Leipzig, Germany
11. Department of Dermatology, General Hospital of Goerlitz, Goerlitz, Germany
12. Department of Dermatology, General Hospital of Krefeld, Krefeld, Germany
13. Department of Dermatology and Allergology, University Hospital of Ulm, Ulm, Germany
14. Department of Dermatology, University of Cologne, Cologne, Germany
15. Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany
16. Department of Dermatology and Allergology, Hospital of Bremen-Mitte, Bremen, Germany
17. Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Munich, Germany
18. Departement of Dermatology, Vital Clinic, Alzenau, Germany
19. Department of Dermatology, Hospital of Luedenscheid, Luedenscheid, Germany
20. Department of Dermatology, Venereology and Allergology, University School of Medicine Essen-Duisburg, Hufelandstrasse 55, Essen, 45122, Germany
文摘
Background Pyoderma gangrenosum (PG) is a rarely diagnosed ulcerative neutrophilic dermatosis with unknown origin that has been poorly characterized in clinical studies so far. Consequently there have been significant discussions about its associated factors and comorbidities. The aim of our multicenter study was to analyze current data from patients in dermatologic wound care centers in Germany in order to describe associated factors and comorbidities in patients with PG. Methods Retrospective clinical investigation of patients with PG from dermatologic wound care centers in Germany. Results We received data from 259 patients with PG from 20 different dermatologic wound care centers in Germany. Of these 142 (54.8%) patients were female, 117 (45.2%) were male; with an age range of 21 to 95 years, and a mean of 58 years. In our patient population we found 45.6% with anemia, 44.8% with endocrine diseases, 12.4% with internal malignancies, 9.3% with chronic inflammatory bowel diseases and 4.3% with elevated creatinine levels. Moreover 25.5% of all patients had a diabetes mellitus with some aspects of potential association with the metabolic syndrome. Conclusions Our study describes one of the world’s largest populations with PG. Beside the well-known association with chronic bowel diseases and neoplasms, a potentially relevant new aspect is an association with endocrine diseases, in particular the metabolic syndrome, thyroid dysfunctions and renal disorders. Our findings represent clinically relevant new aspects. This may help to describe the patients-characteristics and help to understand the underlying pathophysiology in these often misdiagnosed patients.