Significance of erythema nodosum and pyoderma gangrenosum in inflammatory bowel diseases: a cohort study of 2402 patients
- PMID: 18794711
- DOI: 10.1097/MD.0b013e318187cc9c
Significance of erythema nodosum and pyoderma gangrenosum in inflammatory bowel diseases: a cohort study of 2402 patients
Abstract
Erythema nodosum and pyoderma gangrenosum are the most common cutaneous manifestations in inflammatory bowel diseases (IBD). We conducted the current study to assess the cumulative prevalence of erythema nodosum and pyoderma gangrenosum in patients with IBD and to appraise their association with demographic, clinical, and prognostic factors related to IBD. Between 2000 and 2005, data for all patients with IBD at our gastroenterology department were prospectively and systematically collected using a standardized protocol. Among 2402 patients (1521 diagnosed with Crohn disease [63.3%] and 744 with ulcerative colitis [31.0%]), 140 (5.8%) had at least 1 skin manifestation. The most frequent dermatologic symptoms were erythema nodosum (4.0%) and pyoderma gangrenosum (0.75%). In multivariate analyses, erythema nodosum was significantly and independently associated with a diagnosis of Crohn disease (p < 0.001), female sex (p < 0.001), eye and joint involvement (p < 0.001), and pyoderma gangrenosum (p < 0.0001). Among patients with Crohn disease, erythema nodosum was associated with isolated colonic involvement (p = 0.0001). Pyoderma gangrenosum was significantly and independently associated with black African origin (p = 0.003), familial history of ulcerative colitis (p = 0.0005), uninterrupted pancolitis as the initial location of IBD (p = 0.03), permanent stoma (p = 0.002), eye involvement (p = 0.001), and erythema nodosum (p < 0.0001). It is noteworthy that the association between pyoderma gangrenosum and permanent stoma persisted after exclusion of patients with peristomal pyoderma gangrenosum (p = 0.07). In conclusion, neither erythema nodosum nor pyoderma gangrenosum was significantly associated with the severity criteria in IBD; however, their occurrence may reflect a peculiar phenotype among affected patients.
Similar articles
-
Predictive factors for erythema nodosum and pyoderma gangrenosum in inflammatory bowel disease.J Gastroenterol Hepatol. 2014 Feb;29(2):291-5. doi: 10.1111/jgh.12352. J Gastroenterol Hepatol. 2014. PMID: 23927379
-
Concomitant occurrence of pyoderma gangrenosum and erythema nodosum in inflammatory bowel disease.Isr Med Assoc J. 2014 Mar;16(3):168-70. Isr Med Assoc J. 2014. PMID: 24761705
-
[The role of biologic therapy in the treatment of extraintestinal manifestations and complications of inflammatory bowel disease].Acta Med Croatica. 2013 Apr;67(2):195-201. Acta Med Croatica. 2013. PMID: 24471303 Review. Croatian.
-
Erythema nodosum and pyoderma gangrenosum in 50 patients with Crohn's disease.Can J Gastroenterol. 2005 Oct;19(10):603-6. doi: 10.1155/2005/323914. Can J Gastroenterol. 2005. PMID: 16247522
-
Disease-related and drug-induced skin manifestations in inflammatory bowel disease.Expert Rev Gastroenterol Hepatol. 2017 Mar;11(3):203-214. doi: 10.1080/17474124.2017.1283985. Epub 2017 Feb 1. Expert Rev Gastroenterol Hepatol. 2017. PMID: 28095714 Review.
Cited by
-
The causal relationship between inflammatory bowel diseases and erythema nodosum: a bidirectional two-sample mendelian randomization study.BMC Gastroenterol. 2024 Jul 23;24(1):231. doi: 10.1186/s12876-024-03330-8. BMC Gastroenterol. 2024. PMID: 39044191 Free PMC article.
-
Hidden in Plain Sight: A Case Series of Inflammatory Bowel Disease With Dermatologic Lesions As Initial or Concurrent Manifestations.Cureus. 2024 Mar 5;16(3):e55548. doi: 10.7759/cureus.55548. eCollection 2024 Mar. Cureus. 2024. PMID: 38576673 Free PMC article.
-
Causal relationship between inflammatory bowel disease and erythema nodosum: A two-sample bidirectional Mendelian randomization study.Skin Res Technol. 2024 Feb;30(2):e13600. doi: 10.1111/srt.13600. Skin Res Technol. 2024. PMID: 38297958 Free PMC article.
-
Relapse of Ulcerative Colitis with Immune Thrombocytopenia and Pyoderma Gangrenosum Subsequent to Receiving COVID-19 Vaccination.Intern Med. 2024 Mar 1;63(5):665-669. doi: 10.2169/internalmedicine.2969-23. Epub 2024 Jan 2. Intern Med. 2024. PMID: 38171870 Free PMC article.
-
Cutaneous manifestations of inflammatory bowel disease: basic characteristics, therapy, and potential pathophysiological associations.Front Immunol. 2023 Oct 26;14:1234535. doi: 10.3389/fimmu.2023.1234535. eCollection 2023. Front Immunol. 2023. PMID: 37954590 Free PMC article. Review.
References
-
- Adachi Y, Kindzelskii AL, Cookingham G, Shaya S, Moore EC, Todd RF III, Petty HR. Aberrant neutrophil trafficking and metabolic oscillations in severe pyoderma gangrenosum. J Invest Dermatol. 1998;111:259-268.
-
- al-Rimawi HS, Abuekteish FM, Daoud AS, Oboosi MM. Familial pyoderma gangrenosum presenting in infancy. Eur J Pediatr. 1996;155:759-762.
-
- Alberts JH, Sams HH, Miller JL, King Lee Jr. Familial ulcerative pyoderma gangrenosum: a report of 2 kindred. Cutis. 2002;69:427-430.
-
- Barreiro-de Acosta M, Dominguez-Munoz JE, Nunez-Pardo de Vera MC, Lozano-Leon A, Lorenzo A, Pena S. Relationship between clinical features of Crohn's disease and the risk of developing extraintestinal manifestations. Eur J Gastroenterol Hepatol. 2007;19:73-78.
-
- Bernstein CN, Blanchard JF, Rawsthorne P, Yu N. The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol. 2001;96:1116-1122.
MeSH terms
LinkOut - more resources
Full Text Sources