Pediatric Pyoderma Gangrenosum: A Retrospective Review of Clinical Features, Etiologic Associations, and Treatment
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...
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| Veröffentlicht in: | Pediatric dermatology 2017-01, Vol.34 (1), p.39-45 |
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| creator | Schoch, Jennifer J. Tolkachjov, Stanislav N. Cappel, Jonathan A. Gibson, Lawrence E. Davis, Dawn Marie R. |
| description | 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. |
| doi_str_mv | 10.1111/pde.12990 |
| format | Article |
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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.</description><identifier>ISSN: 0736-8046</identifier><identifier>EISSN: 1525-1470</identifier><identifier>DOI: 10.1111/pde.12990</identifier><identifier>PMID: 27699861</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Acne ; Adolescent ; Antibiotics ; Arthritis ; Child ; Child, Preschool ; Children ; Corticosteroids ; Crohn's disease ; Female ; Follow-Up Studies ; Glucocorticoids - therapeutic use ; Head and neck ; Humans ; Inflammatory bowel diseases ; Intestine ; Leukocytes (neutrophilic) ; Male ; Mesalamine - therapeutic use ; Pediatrics ; Pyoderma ; Pyoderma gangrenosum ; Pyoderma Gangrenosum - diagnosis ; Pyoderma Gangrenosum - drug therapy ; Pyoderma Gangrenosum - etiology ; Retrospective Studies ; Skin diseases ; Sulfasalazine ; Sulfasalazine - therapeutic use</subject><ispartof>Pediatric dermatology, 2017-01, Vol.34 (1), p.39-45</ispartof><rights>2016 Wiley Periodicals, Inc.</rights><rights>Copyright © 2017 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4190-19d268e45a111f9ffc74eda6b56bf122ab42acea316c8b27565df46e183e45b13</citedby><cites>FETCH-LOGICAL-c4190-19d268e45a111f9ffc74eda6b56bf122ab42acea316c8b27565df46e183e45b13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpde.12990$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpde.12990$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27699861$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schoch, Jennifer J.</creatorcontrib><creatorcontrib>Tolkachjov, Stanislav N.</creatorcontrib><creatorcontrib>Cappel, Jonathan A.</creatorcontrib><creatorcontrib>Gibson, Lawrence E.</creatorcontrib><creatorcontrib>Davis, Dawn Marie R.</creatorcontrib><title>Pediatric Pyoderma Gangrenosum: A Retrospective Review of Clinical Features, Etiologic Associations, and Treatment</title><title>Pediatric dermatology</title><addtitle>Pediatr Dermatol</addtitle><description>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.</description><subject>Acne</subject><subject>Adolescent</subject><subject>Antibiotics</subject><subject>Arthritis</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Corticosteroids</subject><subject>Crohn's disease</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Head and neck</subject><subject>Humans</subject><subject>Inflammatory bowel diseases</subject><subject>Intestine</subject><subject>Leukocytes (neutrophilic)</subject><subject>Male</subject><subject>Mesalamine - therapeutic use</subject><subject>Pediatrics</subject><subject>Pyoderma</subject><subject>Pyoderma gangrenosum</subject><subject>Pyoderma Gangrenosum - diagnosis</subject><subject>Pyoderma Gangrenosum - drug therapy</subject><subject>Pyoderma Gangrenosum - etiology</subject><subject>Retrospective Studies</subject><subject>Skin diseases</subject><subject>Sulfasalazine</subject><subject>Sulfasalazine - therapeutic use</subject><issn>0736-8046</issn><issn>1525-1470</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kV1LwzAUhoMoOqcX_gEJeKNgZ5I2aevdmPMDBg7R65Cmp5LRNjNpJ_v3RqteCObmkPCch5PzInRCyYSGc7UuYUJZnpMdNKKc8YgmKdlFI5LGIspIIg7QofcrQkgmBN1HBywVeZ4JOkJuCaVRnTMaL7e2BNcofKfaVwet9X1zjaf4CTpn_Rp0ZzYQbhsD79hWeFab1mhV41tQXe_AX-J5Z2xtX4Ns6r3VQWxsG95VW-JnF7AG2u4I7VWq9nD8Xcfo5Xb-PLuPFo93D7PpItIJzUlE85KJDBKuwhervKp0mkCpRMFFUVHGVJEwpUHFVOisYCkXvKwSATSLQ1NB4zE6H7xrZ9968J1sjNdQ16oF23sZQB6LmMYsoGd_0JXtXRumkzRnhPMkZiJQFwOlwz68g0qunWmU20pK5GcQMgQhv4II7Om3sS8aKH_Jn80H4GoA3k0N2_9NcnkzH5QfZS6SQw</recordid><startdate>201701</startdate><enddate>201701</enddate><creator>Schoch, Jennifer J.</creator><creator>Tolkachjov, Stanislav N.</creator><creator>Cappel, Jonathan A.</creator><creator>Gibson, Lawrence E.</creator><creator>Davis, Dawn Marie R.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201701</creationdate><title>Pediatric Pyoderma Gangrenosum: A Retrospective Review of Clinical Features, Etiologic Associations, and Treatment</title><author>Schoch, Jennifer J. ; Tolkachjov, Stanislav N. ; Cappel, Jonathan A. ; Gibson, Lawrence E. ; Davis, Dawn Marie R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4190-19d268e45a111f9ffc74eda6b56bf122ab42acea316c8b27565df46e183e45b13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acne</topic><topic>Adolescent</topic><topic>Antibiotics</topic><topic>Arthritis</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Corticosteroids</topic><topic>Crohn's disease</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Head and neck</topic><topic>Humans</topic><topic>Inflammatory bowel diseases</topic><topic>Intestine</topic><topic>Leukocytes (neutrophilic)</topic><topic>Male</topic><topic>Mesalamine - therapeutic use</topic><topic>Pediatrics</topic><topic>Pyoderma</topic><topic>Pyoderma gangrenosum</topic><topic>Pyoderma Gangrenosum - diagnosis</topic><topic>Pyoderma Gangrenosum - drug therapy</topic><topic>Pyoderma Gangrenosum - etiology</topic><topic>Retrospective Studies</topic><topic>Skin diseases</topic><topic>Sulfasalazine</topic><topic>Sulfasalazine - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schoch, Jennifer J.</creatorcontrib><creatorcontrib>Tolkachjov, Stanislav N.</creatorcontrib><creatorcontrib>Cappel, Jonathan A.</creatorcontrib><creatorcontrib>Gibson, Lawrence E.</creatorcontrib><creatorcontrib>Davis, Dawn Marie R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schoch, Jennifer J.</au><au>Tolkachjov, Stanislav N.</au><au>Cappel, Jonathan A.</au><au>Gibson, Lawrence E.</au><au>Davis, Dawn Marie R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pediatric Pyoderma Gangrenosum: A Retrospective Review of Clinical Features, Etiologic Associations, and Treatment</atitle><jtitle>Pediatric dermatology</jtitle><addtitle>Pediatr Dermatol</addtitle><date>2017-01</date><risdate>2017</risdate><volume>34</volume><issue>1</issue><spage>39</spage><epage>45</epage><pages>39-45</pages><issn>0736-8046</issn><eissn>1525-1470</eissn><abstract>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.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27699861</pmid><doi>10.1111/pde.12990</doi><tpages>7</tpages></addata></record> |
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| subjects | Acne Adolescent Antibiotics Arthritis Child Child, Preschool Children Corticosteroids Crohn's disease Female Follow-Up Studies Glucocorticoids - therapeutic use Head and neck Humans Inflammatory bowel diseases Intestine Leukocytes (neutrophilic) Male Mesalamine - therapeutic use Pediatrics Pyoderma Pyoderma gangrenosum Pyoderma Gangrenosum - diagnosis Pyoderma Gangrenosum - drug therapy Pyoderma Gangrenosum - etiology Retrospective Studies Skin diseases Sulfasalazine Sulfasalazine - therapeutic use |
| title | Pediatric Pyoderma Gangrenosum: A Retrospective Review of Clinical Features, Etiologic Associations, and Treatment |
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