背景:坏疽性脓皮病(PG)是一种以顽固性皮肤溃疡为特征的慢性疾病。
目的:我们的目的是评估人口统计,临床特征,治疗和影响PG患者治疗反应的因素。
方法:我们对12个三级护理中心进行了一项多中心研究。我们回顾性分析了2012年至2022年期间被诊断为PG的患者的数据。
结果:我们共纳入239例患者,其中143例为女性,96例为男性,平均年龄54.2±17.4岁。最常见的治疗是全身性类固醇(n=181,75.7%)。在这些患者中,50.8%(n=92)使用全身性类固醇作为唯一的全身性药物,49.2%(n=89)使用至少一种佐剂免疫抑制剂。在回归分析中确定的影响全身性类固醇反应的独立因素是疾病发病年龄≥30岁,负皮,没有白细胞增多,阴性伤口培养,单个病变的存在,没有上肢受累。在本研究中,有18.4%(n=44)的患者使用了生物制剂。我们还分别分析了pathergy阳性PG和早期发作(发病年龄<30岁)PG,因为它们在统计分析过程中揭示了不同的临床特征。
结论:本研究的回顾性性质。
结论:本研究分析了影响治疗反应的因素。此外,我们的结论是,对伴随自身炎症性疾病的pathergy阳性PG和早发性PG的调查是必要的,这两组患者对治疗的抵抗力更强,需要更复杂的治疗。
BACKGROUND: Pyoderma Gangrenosum (PG) is a chronic disease characterized by recalcitrant skin ulcers.
OBJECTIVE: We aimed to evaluate the demographic, clinical characteristics, treatments and factors affecting the treatment responses of patients with PG.
METHODS: We performed a multicenter
study of 12 tertiary care centers. We analyzed the data of the patients who were followed up with a diagnosis of PG between the years 2012‒2022 retrospectively.
RESULTS: We included a total of 239 patients of whom 143 were female and 96 were male, with an average age of 54.2 ± 17.4 years. The most common treatment was systemic steroids (n = 181, 75.7%). Among these patients, 50.8% (n = 92) used systemic steroids as the sole systemic agent, while 49.2% (n = 89) used at least one adjuvant immunosuppressive agent. The independent factors determined in regression analysis to influence response to systemic steroids positively were disease onset age ≥ 30-years, negative pathergy, absence of leukocytosis, negative wound culture, presence of a single lesion, and absence of upper extremity involvement. Biological agents were used in 18.4% (n = 44) of the patients in the present
study. We also analyzed pathergy positive PG and early onset (onset age < 30) PG separately due to their distinct clinical features which were revealed during statistical analysis.
CONCLUSIONS: Retrospective nature of the present
study.
CONCLUSIONS: Analyses of the factors influencing treatment responses are addressed in this
study. Also, we concluded that investigation for accompanying autoinflammatory diseases of pathergy positive PG and early onset PG is necessary and the patients in these two groups are more resistant to treatment, necessitating more complicated treatments.