The following is a summary of “Mortality and Autopsy Findings in Patients with Pyoderma Gangrenosum: A Multi-Institutional Series,” published in the January 2024 issue of Dermatology by Shakshouk, et al.
Pyoderma gangrenosum (PG) is a rare ulcerative skin condition associated with an elevated mortality risk compared to the general population. However, the factors contributing to this increased mortality risk are poorly understood. Misdiagnosis is prevalent in PG cases, and many studies suffer from the inclusion of misdiagnosed cases. For a study, researchers sought to examine autopsy findings, determine causes of death, and identify factors potentially exacerbating outcomes among deceased patients with confirmed PG.
They retrospectively reviewed data from electronic medical records at five academic hospitals. A search was performed for deceased patients diagnosed with PG who underwent autopsy between 2010 and 2020. They present a descriptive analysis of 11 patients, detailing their clinical characteristics, causes of death, and autopsy findings.
The average age at death was 62.9 years. Seven patients had at least one underlying condition associated with PG, such as inflammatory bowel disease, inflammatory arthritis, or a hematologic disorder. The primary cause of death was infection (n = 6, 54.5%), followed by pulmonary embolism (n = 3, 27.3%) and myelodysplastic syndrome (n = 2, 18.2%). At the time of death, six patients (54.5%) were receiving systemic steroids.
The onset of PG may reduce life expectancy, particularly among individuals with associated underlying conditions. Moreover, standard treatments for PG, such as systemic steroids, may contribute to the risk of fatal complications. Recognizing the heightened risk of infection, thrombosis, and malignancy in individuals with PG is crucial for effective management. Further investigation is warranted to elucidate the relationship between PG and thromboembolism.
Reference: karger.com/drm/article-abstract/240/2/352/894045/Mortality-and-Autopsy-Findings-in-Patients-with