Erythema nodosum progressing to pyoderma gangrenosum as a complication of Crohn’s disease

Gellert, A R; Green, E. S.; Beck, Eric; Ridley, C. M.

doi:10.1136/pgmj.59.698.791

Cited by 11 publications

(6 citation statements)

References 12 publications

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“…Nevertheless, even if it is usually managed successfully with combined topical therapy and general treatment of the underlying IBD, in some cases it may have a more severe course [32]. Pyoderma gangrenosum was previously reported as progressing from erythema nodosum lesions [33], which could partially account for the increased frequency of erythema nodosum compared to pyoderma gangrenosum. Ophthalmological manifestations are another type of wellrecognized immune-related extraintestinal manifestations of IBD, with a reported prevalence of up to 13%, more common in CD than in UC patients [34,35].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Extraintestinal Manifestations in Inflammatory Bowel Diseases - Data from the Romanian National Registry

Sîngeap

Gîrleanu

Diculescu

et al. 2021

JGLD

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Background and Aims: Identifying the risk factors for extraintestinal manifestations (EIMs) in inflammatory bowel diseases (IBD) may optimize the therapeutic decision. We aimed to assess the prevalence of EIMs in IBD patients in Romania and to determine the risk factors. Methods: We analyzed 2,626 patients registered in the Romanian IBD Prospect National Registry. We performed a descriptive cross-sectional study to assess the point prevalence of EIMs, calculating global prevalence and analyzing the different types of EIMs and their respective frequencies were carried out. Demographic and clinical risk factors were researched as possible predictors for EIMs development, based on the results of the univariate and multivariate logistic regression analysis. Results: The overall point prevalence of EIMs was 16.3%. A significantly higher frequency of EIMs in Crohn’s disease (CD) was noted in comparison to ulcerative colitis (UC) and IBD unclassified (IBDU) (23.2% vs 11.3% and 16.3%, respectively, p<0.001). The most frequent type of EIM was peripheral arthropathy (8.3%), significantly associated with CD (p<0.001). Univariate analysis highlighted the significant independent common predictive risk factors for EIMs, in both CD and UC patients: female gender, patient’s urban area of origin, anemia, hypoalbuminemia, and high level of C-reactive protein (CRP), while significant independent IBD phenotype-related risk factors were ileocolonic location and concomitant involvement of upper gastrointestinal tract for CD, non-smoker status and both moderate and severe disease activity for UC (p<0.05). Multivariate analysis determined that female CD patients with moderate or severe disease activity, with other than isolated ileal disease, and female UC patients with moderate or severe extensive colitis are the most likely to develop EIMs. Conclusions: IBD patients are experiencing EIMs in a large proportion, with higher rates for CD. As EIMs negatively affect patient outcomes, foreseeing the risk by identifying independent and associated predictive factors could be a first step to optimal work-up and treatment.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Extraintestinal Manifestations in Inflammatory Bowel Diseases - Data from the Romanian National Registry

Sîngeap

Gîrleanu

Diculescu

et al. 2021

JGLD

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“…Cases of pyoderma gangrenosum evolving from preceding erythema nodosum also have been reported. 79 The diagnosis is made clinically, although wound swabs and a skin biopsy may be needed to exclude other conditions. There are no pathognomonic histological features, generally revealing only diffuse neutrophil infiltration and dermolysis.…”

Section: Eim Of the Skinmentioning

confidence: 99%

Extraintestinal Manifestations of Inflammatory Bowel Disease

Vavricka

Schoepfer

Scharl

et al. 2015

Inflammatory Bowel Diseases

658

544

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“…For pediatric patients, Dotson et al (12) also reported that pyoderma gangrenosum was more common in CD than UC among a total of 1,009 patients with a total prevalence of 0.3% (3 of 1,009). Pyoderma gangrenosum is known to be related with colonic involvement, EN, and arthritis (2,50,51). The correlation with the underlying disease activity of pyoderma gangrenosum is not clear to date; however, it usually resolves with treatment of the underlying IBD (2,15,51).…”

Section: Pyoderma Gangrenosummentioning

confidence: 99%

The difference in extraintestinal manifestations of inflammatory bowel disease for children and adults

2019

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Extraintestinal manifestations (EIMs) are frequently observed in adult and pediatric patients with inflammatory bowel disease (IBD). The most common EIMs involve the joints, skin, and eyes, but they can affect various organs and result in significant morbidity. Since EIMs can appear years before the diagnosis of IBD is made, clinicians should be aware of their various manifestations to help decrease diagnostic delay of IBD and establish appropriate treatment plans.

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Erythema nodosum progressing to pyoderma gangrenosum as a complication of Crohn’s disease

Cited by 11 publications

References 12 publications

Risk Factors for Extraintestinal Manifestations in Inflammatory Bowel Diseases - Data from the Romanian National Registry

Risk Factors for Extraintestinal Manifestations in Inflammatory Bowel Diseases - Data from the Romanian National Registry

Extraintestinal Manifestations of Inflammatory Bowel Disease

The difference in extraintestinal manifestations of inflammatory bowel disease for children and adults

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