Increased morbidities in pyoderma gangrenosum with extensive surgical debridement in Taiwan: A case series

OBJECTIVE: Delayed diagnosis and consequent extensive debridement in cases of pyoderma gangrenosum (PG) may lead to poor wound healing and unfavourable prognosis. We aimed to evaluate the epidemiological and clinical features of PG in Taiwan and investigate the clinical courses of patients who underwent extensive surgical debridement.

METHOD: In this retrospective study, patients diagnosed with PG at a referral centre in Taiwan between 2001 and 2021 were recruited. The patients were divided into a debrided group and a non-debrided group.

RESULTS: The cohort comprised a total of 15 patients, five of whom were in the debrided group and 10 in the non-debrided group. Among all 15 patients, the average age at diagnosis was 40 years with a male preponderance (67%). PG tended to involve multiple sites (73%), the lower limbs (87%), ulcerations (80%) and had a diameter <10cm (93%). Seven patients (47%) had medical comorbidities, including inflammatory bowel disease (20%) and hypertension (20%). Ulcerative manifestations, lack of typical associated comorbidities, delayed diagnosis, prolonged lengths of hospitalisation, and high cumulative doses of systemic corticosteroids were observed in the debrided group.

CONCLUSION: This is the first study to describe the epidemiological and clinical characteristics of PG in Taiwan in English to our knowledge. The results were mostly consistent with the existing literature, except an apparent male preponderance. Moreover, we highlight the importance of accurate diagnosis and avoidance of aggressive surgical debridement in patients with PG for both dermatologist and non-dermatologist.