Background: The question of whether solid malignancies (SMs) are associated with pyoderma gangrenosum (PG) remains to be conclusively answered.Objective: To evaluate the risk of SM among patients with PG and the odds of PG after a diagnosis of SM.Methods: A population-based retrospective cohort study was conducted to study the risk for SM in patients with PG (n = 302) as compared with age-, sex-and ethnicity-matched control subjects (n = 1799). A case-control design was used to estimate the odds of PG in those with a preexisting history of SM. Results:The prevalence of a preexisting SM was comparable in patients with PG and controls (7.5% vs. 8.8%, respectively; P = 0.490). The odds of having PG following a diagnosis of a SM was not statistically increased (OR, 0.85; 95% CI, 0.53-1.36). The incidence of SM was 6.8 (95% CI, 3.5-12.2) and 7.9 (95% CI, 6.1-10.1) per 1000 person-years among patients with PG and controls, respectively. Patients with PG were not more likely to develop SM as compared to controls (HR, 0.86; 95% CI, 0.44-1.69). Patients with a dual diagnosis of PG and SM were older and had more frequent comorbid conditions and increased mortality.Conclusions: SM is not associated with provoking PG, and patients with PG are not at an increased risk of developing SM. A thorough routine screening for SM in patients with new-onset PG is an unnecessary approach based on the study findings.

Background Current treatment paradigms in anti‐p200 pemphigoid rely on low levels of evidence, primarily originating from case reports and case series. Objective To systematically review the utilized treatment modalities for anti‐p200 pemphigoid and to synthesize the available clinical outcomes of treated patients. Methods We conducted a systematic review of the literature using Ovid‐Medline (1946–2018), Embase (1947–2018) and Web of Science (1900–2018) databases with a broad and inclusive search strategy along with a subsequent search of retrieved articles. All case reports and case series of patients with anti‐p200 pemphigoid were included. Results Sixty‐eight eligible studies comprising 113 anti‐p200 pemphigoid patients with a mean age of 65.5 years were included in the qualitative synthesis. The clinical outcome of patients following treatment was reported for 91 (80.5%) patients, of whom 83 (91.2%) had achieved complete remission at least once. Complete remission on‐therapy was observed in 51 (56.0%) and complete remission off‐therapy in 12 (13.2%) patients. Thirty‐six (39.6%) patients had experienced at least one flare during the duration of follow‐up. A combination of systemic corticosteroids and adjuvant immunomodulatory agents was the leading therapeutic approach (63.0%) required for disease control. Systemic and topical corticosteroids as monotherapy were sufficient to control the disease in 19.6% and 13.0% of cases, respectively. Dapsone was the most commonly used (41.3%) adjuvant agent. The highest rates of complete remission were achieved in patients managed by systemic corticosteroids as monotherapy (100%) and in those managed by systemic corticosteroids with adjuvant agents (90.7%). Conversely, 45.5% of patients treated only by topical corticosteroids experienced at least one relapse during follow‐up. Conclusion The vast majority of patients had reached a complete remission during the course of the disease, whereas a considerable proportion of patients experienced at least one relapse. A combination of systemic corticosteroids and adjuvant immunomodulatory agents was the most frequently utilized therapeutic approach.

skin diseases reflected in the Cochrane Database of Systematic Reviews, 5 where psoriasis and decubitus ulcer were overrepresented diseases in terms of research, whereas urticaria and bacterial skin infections were underrepresented. A strength of this study is the interrelationship made between two large national datasets, from studies designed to be representative both of outpatient consultations and research activity in Spain, 3,4 and data from the GBDS. Among the limitations are that this study is restricted to 14 groups of diseases and only outpatient consultations, which may not be representative of all skin conditions, and that the unweighted number of publications might not be a good measure of research activity. Another limitation is that the periods of the three studies did not match exactly, which could affect the comparability of the data. However, burden of skin diseases and frequency of consultations are unlikely to differ from those in the period of the MaIND study. Our data suggest that melanoma might be overrepresented in research, whereas acne and viral infections could be underrepresented according to the demand for consultations and the disease burden. Research in psoriasis and dermatitis is proportional to the disease burden and demand for consultations whereas research in NMSC is scarce according to demand for consultations but disproportionate according to disease burden. Research priorities, should be conscious decisions that take into account quantitative data, such as the burden of skin conditions and the demand for clinical assistance in order to sort the need for resources, and qualitative research, such as James Lind Alliance Prioritization exercises, could be useful to select the main research questions within each topic.

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