Pyoderma Gangrenosum Primarily Affects Women and Older Patients

Pyoderma gangrenosum
Pyoderma gangrenosum
This analysis supports prior descriptive studies showing that the majority of pyoderma gangrenosum cases occur in women and in elderly patients.

An electronic database analysis found that pyoderma gangrenosum (PG) primarily affects women and individuals 50 years of age or older, giving more characteristic insight into this rare neutrophilic dermatosis. Findings from this analysis were published in the Journal of the American Academy of Dermatology.

The study was a cross-sectional analysis of electronic health record data that included patients with PG (n=1971). Data were obtained from a database that comprises more than 58 million unique patients from 27 different integrated healthcare organizations. The primary goal of the analysis was to calculate the prevalence of PG among adults as well as to identify key characteristics associated with the disorder.

Among the entire study population, the age- and sex-standardized prevalence of PG was 5.8 cases (95% CI, 5.6-6.1) per 100,000 adults. In the adjusted analysis, prevalence was higher in women (7.1 cases [95% CI, 6.7-7.5] per 100,000) than in men (4.4 cases [95% CI, 4.0-4.7] per 100,000). Women had a 1.8-fold higher prevalence of PG across all age groups compared with men.

The majority of patients with PG were aged 50 years or older (70%), with those between the ages of 70 to 79 years having the highest standardized prevalence of the disorder (9.8 cases [95% CI, 8.8-10.9] per 100,000). No difference between white and African American patients was found in terms of the prevalence of PG.

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Limitations of the analysis included the retrospective review of electronic medical data as well as the inability to verify the diagnosis of PG.

The analysis of what the researchers believe is the largest and perhaps the most heterogeneous group of patients with PG ever described suggest that “gender-specific differences in hormone levels may contribute to immune dysregulation in PG.” Findings from this study may further “support future large scale epidemiologic investigations of risk factors, associated comorbidities, and health outcomes,” the researchers wrote.

Disclosure: Several of the study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Xu A, Balgobind A, Strunk A, Garg A, Alloo A. Prevalence estimates for pyoderma gangrenosum in the United States: An age- and sex-adjusted population analysis [published online August 7, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.08.001