Pyoderma gangrenosum in hematologic malignancies: A systematic review - 12/02/20

Doi : 10.1016/j.jaad.2019.09.032

Carmen M. Montagnon, MD ^a, Elizabeth A. Fracica, MD, MPH ^b, Archna A. Patel, BS ^c, Michael J. Camilleri, MD ^d, M. Hassan Murad, MD, MPH ^e, David Dingli, MD, PhD ^f, David A. Wetter, MD ^d, Stanislav N. Tolkachjov, MD ^g,^⁎
^a Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
^b Johns Hopkins Bayview Medical Center, Baltimore, Maryland
^c Alix School of Medicine, Mayo Clinic, Rochester, Minnesota
^d Department of Dermatology, Mayo Clinic, Rochester, Minnesota
^e Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota
^f Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
^g Epiphany Dermatology, Dallas, Texas

^∗Reprint requests: Stanislav N. Tolkachjov, MD, Epiphany Dermatology, 9191 Kyser Way, Bldg 3, Frisco, TX 75033.Epiphany Dermatology9191 Kyser WayBldg 3FriscoTX75033

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 12 February 2020

Abstract

Background

Pyoderma gangrenosum (PG) is a devastating neutrophilic dermatosis that may be associated with trauma or systemic diseases. The associations, characteristics, and temporal relationship of PG with hematologic malignancies are not well understood.

Objective

We performed a systematic review of PG associated with hematologic malignancies using data from case reports, case series, and retrospective studies.

Methods

We searched MEDLINE, EMBASE, Scopus, and Web of Science from each database's inception to December 12, 2018. Two reviewers independently selected studies and extracted data.

Results

Two hundred seventy-nine publications met the inclusion criteria (340 cases). Myelodysplastic syndrome (MDS) was the most commonly reported hematologic malignancy associated with PG, followed by monoclonal gammopathy of undetermined significance and acute myeloid leukemia. The mean age of patients was 56.5 years, with males being more common. There was a predominance of the ulcerative PG subtype and multifocal distributions across all hematologic malignancies. The majority of MDS cases preceded PG, which was reversed for MGUS.

Limitations

The data were limited by reporting bias because PG subtypes rely on the rendered diagnosis reported. In addition, the classification for hematologic malignancies has evolved since 1978.

Conclusion

Patients with PG should be evaluated for hematologic malignancies, with MDS being the most common.

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Key words : blood, gammopathy, gangrenosum, hematology, leukemia, lymphoma, myelodysplastic, myeloid, pyoderma, ulcer

Abbreviations used : AML, IL, MGUS, ND, PG

Esquema

Methods

Literature search

Inclusion criteria

Data extraction and assessment

Methodologic quality

Results

Study characteristics

Patient characteristics

Discussion

	Funding sources: None
	Conflicts of interest: None declared.
	Presented as an ePoster at the American Academy of Dermatology 2019 Annual Meeting, Washington, DC, March 1-5, 2019.