479 A retrospective review of 23 cases of pyoderma gangrenosum: Effects of comorbid conditions on treatment response

Abstract

Pyoderma gangrenosum (PG) is frequently associated with comorbid conditions such as inflammatory bowel disease, rheumatoid arthritis, and malignancy, but there is a paucity of data on how these comorbid conditions impact the response of PG to treatment. We retrospectively review 23 cases of PG treated at one medical institution to understand the effect that comorbid conditions have on the time to resolution of the PG. Of the 23 cases examined, 10 (43%) are associated with an inflammatory bowel disease or autoimmune hepatobiliary disease (PG with IBD). 13 (57%) are associated with other comorbid conditions or with no known comorbid condition (PG without IBD). We observe a clinically and statistically significant variation in treatment outcomes between these two groups. The median time for lesions to heal in PG with IBD was 15 months versus 54 months in PG without IBD (p < 0.001). 7 (70%) of the PG with IBD lesions healed by the end of the study versus 2 (16.7%) of the PG without IBD lesions. No patients in the PG with IBD group died during before the end of the study, but 2 (15%) of the PG without IBD group died before the end of the study. We speculate as to possible reasons for the disparate outcomes in the PG with IBD and PG without IBD groups.