HS May Affect Systemic Therapy Effectiveness in Pyoderma Gangrenosum

Systemic therapy effectiveness in patients with pyoderma gangrenosum (PG) may depend on underlying diseases, according to a study published in Wound Repair and Regeneration.

Researchers aimed to investigate the spectrum of diseases associated with PG and correlate disease associations with effectiveness of therapy in a study using Johns Hopkins medical records. The records included 220 patients with an ICD-9 code of 686.01 for PG. Of these, 130 met the inclusion/exclusion criteria for PG.

Comorbid conditions observed in the 130 patients included in the study were inflammatory bowel disease (IBD, 35%), rheumatoid arthritis (RA, 12%), hidradenitis suppurativa (HS, 14%), and monoclonal gammopathy (12%). Patients with PG and HS were more likely to be African American and had an earlier mean age of onset. In fact, 53% of female African American patients with PG onset before 40 years of age also had HS. Comorbid IBD was found in 38% of patients with PG and RA, 28% of patients with PG and HS, and 27% of patients with PG and monoclonal gammopathy. Infliximab given for active PG resulted in complete ulcer healing in 83% of patients with comorbid HS who received the treatment. This is compared with only 31% of patients without HS.

“Screening patients for associated systemic disease for multiple related illnesses is essential,” concluded the study authors. “Effectiveness of systemic therapy may depend upon the underlying systemic disease; hidradenitis suppurativa may be a specific example,” they added.

Reference
Fischer AH, Jourabchi N, Khalifian S, Lazarus GS. Spectrum of diseases associated with pyoderma gangrenosum and correlation with effectiveness of therapy: new insights on the diagnosis and therapy of comorbid hidradenitis suppurativa. Wound Repair Regen. Published online April 6, 2022. doi:10.1111/wrr.13014