Pyoderma Gangrenosum: A Clinical Study / 대한피부과학회지

ABSTRACT

BACKGROUND: Pyoderma gangrenosum (PG) is a rare noninfectious skin disorder characterized by chronic recurrent painful ulcers. Because of its low incidence and diagnostic difficulty, there were few comprehensive studies of the clinical features of PG in Korea. OBJECTIVE: Our purpose was to delineate the clinical features of PG. METHODS: 22 patients who presented with PG at 6 hospitals of Catholic Medical Center over ten years were enrolled in this study. We reviewed all medical records of the patients. RESULTS: The mean age was 47.9 years. The male to female ratio was 11.4. Cases in children account for 2 out of twenty two. Sixty-one percent of the patients had lesions on their lower legs. The typical ulcerative variant was found in 19 patients, bullous PG in 3 patients. An association with other internal diseases was noted in 9 patients. Two cases were developed in heavy alcoholics. 15 patients were treated with systemic corticosteroid, 12 cases with systemic corticosteroid only, one case with systemic corticosteroid and cyclosporine, one case with systemic corticosteroid and dapsone, one case with systemic corticosteroid, cyclosporine and colchicine. 1 patient was treated with cyclosporine and colchicine, 1 patient with colchcine, rifampicin and antibiotics. Five cases were treated with antibiotics only. In the only systemic corticosteroid therapeutic group, the response rate was 83%. 3 patients experienced recurrence and 3 patients showed positive pathergy reactions. CONCLUSION: PG is a rare disease with the ulcerative variant being most frequent. The lower legs were the most commonly affected sites. PG was accompanied with systemic disease in 46% of the cases. Comparing with foreign literature, the response rate of treatments was generally fine and the recurrence rate was low.