-
The Journal of Investigative Dermatology Jan 2021Pyoderma gangrenosum (PG) is an inflammatory condition characterized by chronic cutaneous ulcerations. There are three proposed PG diagnostic frameworks (Su, PARACELSUS,... (Comparative Study)
Comparative Study
Pyoderma gangrenosum (PG) is an inflammatory condition characterized by chronic cutaneous ulcerations. There are three proposed PG diagnostic frameworks (Su, PARACELSUS, Delphi); however, they lack consensus, and their performance has not yet been validated in a well-defined cohort of patients with PG. In this cross-sectional retrospective cohort study, we sought to evaluate and compare the concordance of these diagnostic frameworks within a single-institution cohort of patients with PG. There were 47 patients from an initial 76 identified by International Classification of Diseases-9 and/or International Classification of Diseases-10 codes, where two PG experts agreed in their diagnosis of PG on the basis of clinical descriptions, photographs, and pathology. This group was the PG cohort by which we evaluated the performance and concordance of the diagnostic frameworks. The PARACELSUS score identified the highest proportion of patients with PG (89% [42 of 47 patients]), followed by Delphi and Su criteria, each at 74% (35 of 47 patients). Assessment of multirater agreement found that the three criteria agreed in their diagnoses for 72% of the patients (95% confidence interval = 60-85%); chance-adjusted agreement was determined to be 0.44 (95% confidence = 0.16-0.68, Fleiss' kappa). Future research should seek to refine these diagnostic frameworks and identify targeted methods of testing to reduce rates of PG misdiagnosis and patient misclassification in clinical trials.
Topics: Cross-Sectional Studies; Humans; Pyoderma Gangrenosum; Retrospective Studies; Skin
PubMed: 32445742
DOI: 10.1016/j.jid.2020.04.019 -
PLoS Neglected Tropical Diseases Nov 2019Skin diseases represent a significant public health problem in most low and middle income settings. Nevertheless, there is a relative paucity of high-quality...
INTRODUCTION
Skin diseases represent a significant public health problem in most low and middle income settings. Nevertheless, there is a relative paucity of high-quality epidemiological data on the prevalence of these conditions.
MATERIALS/METHODS
We conducted two cross-sectional population-based skin-surveys of children (6 months to 9 years old) in the Bijagós Archipelago of Guinea-Bissau during the dry season (February-March 2018) and the wet season (June-July 2018). Following a period of training, a nurse performed a standardised examination for communicable dermatoses for each participant. We calculated the prevalence of each skin condition and investigated demographic associations.
RESULTS
1062 children were enrolled in the dry season survey of whom 318 (29.9%) had at least one skin diseases. The most common diagnosis was tinea capitis (154/1062, 14.5% - 95% CI 12.5-16.8%) followed by tinea corporis (84/1062, 7.9% - 95% CI 6.4-9.7%), pyoderma (82/1062, 7.7% - 95% CI 6.2-9.5%) and scabies (56/1062. 5.2% - 95%CI 4.0-6.8%). 320 children were enrolled in the wet season survey of whom 121 (37.8%) had at least one skin problem. Tinea capitis remained the most common diagnosis (79/320, 24.7% - 95% CI 20.1-29.9%), followed by pyoderma (38/320, 11.9% - 95% CI 8.6-16.1%), tinea corporis (23/320, 7.2% - 95% 4.7-10.7%) and scabies (6/320, 1.9% - 95% CI 0.8-4.2%).
CONCLUSIONS
Our study, which utilised robust population-based cluster random sampling methodology, demonstrates the substantial disease burden caused by common communicable dermatoses in this setting. Given these findings, there is a need to consider common dermatoses as part of Universal Health Coverage to deliver 'skin-health for all'.
Topics: Child; Child, Preschool; Cross-Sectional Studies; Demography; Developing Countries; Female; Guinea-Bissau; Humans; Infant; Male; Prevalence; Pyoderma; Scabies; Seasons; Tinea
PubMed: 31738757
DOI: 10.1371/journal.pntd.0007820 -
Journal of the European Academy of... Aug 2022
Topics: COVID-19; COVID-19 Vaccines; Hemorrhage; Humans; Pyoderma Gangrenosum; Skin Diseases, Vesiculobullous; Vaccination
PubMed: 35398933
DOI: 10.1111/jdv.18132 -
Medicine Jan 2000Pyoderma gangrenosum (PG) is an idiopathic, inflammatory, ulcerative disease of undetermined cause. The diagnosis is based on clinical and pathologic features and... (Comparative Study)
Comparative Study Review
Pyoderma gangrenosum (PG) is an idiopathic, inflammatory, ulcerative disease of undetermined cause. The diagnosis is based on clinical and pathologic features and requires exclusion of conditions that produce ulcerations. An atypical bullous variant (atypical pyoderma gangrenosum, APG) exists with clinical features similar to those of Sweet syndrome. Because PG is a rare disease, few large case series have been reported. Pyoderma gangrenosum was first recognized as a unique disease entity in the first half of the 20th century. Cumulative knowledge of PG is based on a handful of case series and multiple individual case reports. To augment that knowledge, we present our experience with a large number of patients over a significant time. We performed a retrospective analysis of the medical records of 86 patients with PG who were evaluated and treated over 12 years at 2 university-based dermatology departments. The mean (+/- standard deviation) age of onset of PG and APG, respectively, was 44.6 +/- 19.7 years and 52.2 +/- 15.3 years. Lower extremity involvement was most common in PG, whereas upper extremity involvement was most common in APG. Associated relevant systemic diseases were seen in 50% of patients. Inflammatory bowel disease was the most common association in patients with PG, whereas hematologic disease or malignancy was most common in those with APG. Although a few patients were managed with local measures or nonimmunosuppressive treatment, the majority required oral corticosteroid therapy, often with systemic immunosuppressive treatment. PG patients required a mean 11.5 +/- 11.1 months of treatment to achieve remission compared with 9.0 +/- 13.7 months for patients with APG. Five patients (5.8%) had disease that was extremely refractory to multiple intensive therapies. The prognosis and disease associations for PG and APG appear to be different. Compared with PG, APG is more often associated with hematologic disease or malignancy, and remits more quickly.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Pyoderma Gangrenosum; Remission Induction; Retrospective Studies; Time Factors
PubMed: 10670408
DOI: 10.1097/00005792-200001000-00004 -
Arthritis and Rheumatism Oct 2004
-
International Journal of Molecular... Jul 2023is the most common opportunistic pathogen in dogs and methicillin resistance (MRSP) has been identified as an emerging problem in canine pyoderma. Here, we evaluated...
is the most common opportunistic pathogen in dogs and methicillin resistance (MRSP) has been identified as an emerging problem in canine pyoderma. Here, we evaluated the antimicrobial resistance (AMR) features and phylogeny of isolated from canine pyoderma cases in Argentina ( = 29) and the United States ( = 29). 62% of isolates showed multi-drug resistance. The AMR genes found: A, Z, , G, A, M, (6')-(2″), in addition to K and A (only found in U.S. isolates). Two point mutations were detected: A(S80I)-A(S84L), and A(D84N)-A(S84L) in one U.S. isolate. A mutation in B (H481N) was found in two isolates from Argentina. SCC type III, SCC type V, ΨSCC were identified in the Argentinian isolates; and SCC type III, SCC type IVg, SCC type V, and SCC type VII variant in the U.S. cohort. Sequence type (ST) ST71 belonging to a dominant clone was found in isolates from both countries, and ST45 only in Argentinian isolates. This is the first study to comparatively analyze the population structure of canine pyoderma-associated isolates in Argentina and in the U.S. It is important to maintain surveillance on populations to monitor AMR and gain further understanding of its evolution and dissemination.
Topics: Dogs; Animals; United States; Anti-Bacterial Agents; Staphylococcal Infections; Argentina; Dog Diseases; Drug Resistance, Bacterial; Genomics; Pyoderma; Microbial Sensitivity Tests
PubMed: 37511121
DOI: 10.3390/ijms241411361 -
CMAJ : Canadian Medical Association... May 2020
Topics: Aged, 80 and over; Antineoplastic Agents; Carcinoma, Renal Cell; Female; Humans; Kidney Neoplasms; Pyoderma Gangrenosum; Sunitinib
PubMed: 32452467
DOI: 10.1503/cmaj.191165 -
Indian Journal of Dermatology,... 2020
Topics: Female; Fingers; Glucocorticoids; Humans; Leg; Middle Aged; Prednisolone; Pyoderma Gangrenosum
PubMed: 32769316
DOI: 10.4103/ijdvl.IJDVL_840_19 -
Revue Medicale de Liege May 2017Pyoderma gangrenosum (PG) is a rare pustular and ulcerative inflammatory disease belonging to the group of neutrophilic dermatoses. It is frequently associated with...
Pyoderma gangrenosum (PG) is a rare pustular and ulcerative inflammatory disease belonging to the group of neutrophilic dermatoses. It is frequently associated with systemic immune diseases. In this context the PG can be exceptionally triggered by tissue trauma such as surgery (pathergy). We report the case of a patient with stabilized rheumatoid arthritis who developed aggressive and disseminated PG at all surgical wounds following an abdominal dermolipectomy associated with breast pexy. Systemic corticosteroid methylprednisolone allowed a rapid control of skin ulcerations. In the aftermath of an intervention, PG is often confused with a bacterial skin-necrotizing panniculitis. The recognition of the inflammatory nature of cutaneous symptoms is crucial to quickly start an immunosuppressive treatment and limit scarring sequelae. Our case also illustrates the need to consider any history of dysimmune inflammatory or oncohematological disease as a risk factor before surgery, even if the latter are stabilized.
Topics: Arthritis, Rheumatoid; Female; Glucocorticoids; Humans; Methylprednisolone; Middle Aged; Postoperative Complications; Pyoderma Gangrenosum
PubMed: 28520320
DOI: No ID Found -
BMC Research Notes Feb 2023Staphylococcus pseudintermedius is an opportunistic pathogen commonly associated with skin infections in dogs. Twenty-three methicillin-resistant S. pseudintermedius...
Staphylococcus pseudintermedius is an opportunistic pathogen commonly associated with skin infections in dogs. Twenty-three methicillin-resistant S. pseudintermedius (MRSP) isolated in Argentina from dogs with pyoderma were analyzed using whole genome sequencing (WGS) and classified into sequence types (ST) by multilocus sequence typing (MLST) and staphylococcal chromosome cassette mec (SCCmec) types.Based on the WGS analysis, MLST, and SCCmec type results, we report for the first time in Argentina two MRSP strains, one each, belonging to ST71-SCCmec III and ST45-ΨSCCmec from dogs with pyoderma. We also identified seven isolates with ST339, which had been previously reported in only two isolates in Argentina. Additionally, we identified ten MRSP isolates harboring variants of the SCCmec V found in S. aureus, seven SCCmec V (5C2&5) with two ccrC1 recombinases, and three SCCmec V (5C2) with one ccrC1 recombinase.Our findings provide important insights into the evolution and geographic spread of these hypervirulent dominant clones that threaten the health of our companion animals and represent a significant risk for zoonotic infections.
Topics: Dogs; Animals; Anti-Bacterial Agents; Staphylococcal Infections; Multilocus Sequence Typing; Staphylococcus aureus; Argentina; Dog Diseases; Pyoderma; Chromosomes; Microbial Sensitivity Tests
PubMed: 36823518
DOI: 10.1186/s13104-023-06285-3