Pyoderma gangrenosum in hematologic malignancies: A systematic review.


Journal

Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 08 07 2019
revised: 15 08 2019
accepted: 17 09 2019
pubmed: 29 9 2019
medline: 22 1 2021
entrez: 28 9 2019
Statut: ppublish

Résumé

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. We performed a systematic review of PG associated with hematologic malignancies using data from case reports, case series, and retrospective studies. 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. 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. 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. Patients with PG should be evaluated for hematologic malignancies, with MDS being the most common.

Sections du résumé

BACKGROUND 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 OBJECTIVE
We performed a systematic review of PG associated with hematologic malignancies using data from case reports, case series, and retrospective studies.
METHODS 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 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 CONCLUSIONS
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 CONCLUSIONS
Patients with PG should be evaluated for hematologic malignancies, with MDS being the most common.

Identifiants

pubmed: 31560977
pii: S0190-9622(19)32776-8
doi: 10.1016/j.jaad.2019.09.032
pii:
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1346-1359

Informations de copyright

Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Carmen M Montagnon (CM)

Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.

Elizabeth A Fracica (EA)

Johns Hopkins Bayview Medical Center, Baltimore, Maryland.

Archna A Patel (AA)

Alix School of Medicine, Mayo Clinic, Rochester, Minnesota.

Michael J Camilleri (MJ)

Department of Dermatology, Mayo Clinic, Rochester, Minnesota.

M Hassan Murad (MH)

Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota.

David Dingli (D)

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.

David A Wetter (DA)

Department of Dermatology, Mayo Clinic, Rochester, Minnesota.

Stanislav N Tolkachjov (SN)

Epiphany Dermatology, Dallas, Texas. Electronic address: stan.tolkachjov@gmail.com.

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Classifications MeSH