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Pediatric Pyoderma Gangrenosum: A Retrospective Review of Clinical Features, Etiologic Associations, and Treatment
Author(s) -
Schoch Jennifer J.,
Tolkachjov Stanislav N.,
Cappel Jonathan A.,
Gibson Lawrence E.,
Davis Dawn Marie R.
Publication year - 2016
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.12990
Subject(s) - medicine , pyoderma gangrenosum , dermatology , sulfasalazine , retrospective cohort study , arthritis , inflammatory bowel disease , clindamycin , disease , surgery , pediatrics , ulcerative colitis , antibiotics , microbiology and biotechnology , biology
Background/Objectives Pyoderma gangrenosum ( PG ) is a neutrophilic dermatosis rarely seen in children. Its features have not been well characterized in children. We sought to characterize the clinical features, etiologic associations, and treatment of PG in children younger than 18 years. Methods We performed a retrospective review of children younger than 18 years with PG at the Mayo Clinic from January 1976 to August 2013. Results Thirteen children with PG were identified ( n = 8; 62% female). All had ulcerations, with 62% having pustular lesions. Sites of involvement included the trunk (77%), lower extremities (77%), upper extremities (38%), and head and neck (38%). Nine (69%) had an underlying comorbidity, including seven with Crohn's disease (54%), one with juvenile idiopathic arthritis (8%), and one with pyogenic arthritis, pyoderma gangrenosum, and acne syndrome (8%). Treatments included topical or local care (92%) and systemic therapies (85%) such as oral corticosteroids (62%) and sulfasalazine or related 5‐aminosalicylate drugs (46%). The clinical course did not correlate with that of the underlying systemic disease and response to treatment varied. Conclusion Pediatric PG has a more varied anatomic distribution and a greater predominance of pustular lesions than PG in adults and a strong association with inflammatory bowel disease.