Associated factors and comorbidities in patients with pyoderma gangrenosum in Germany: a retrospective multicentric analysis in 259 patients

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.