Overall and Subgroup Prevalence of Pyoderma Gangrenosum Among Patients with Hidradenitis Suppurativa: a population based analysis in the United States

Publication date: Available online 7 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): R. Tannenbaum, A. Strunk, A. Garg

Abstract

Background

Hidradenitis suppurativa (HS) and pyoderma gangrenosum (PG) are reported to coexist, although prevalence of PG among HS patients has not been systematically evaluated.

Objective

To evaluate PG prevalence among HS patients.

Methods

Cross-sectional analysis of adults with PG among HS and non-HS patients using electronic health records data from a population-based sample of 55 million patients.

Results

Prevalence of PG among 68,232 HS patients was 0.18% (125/68,232), compared to 0.01% (1,835/31,435,166) among those without HS (p<0.0001). Prevalence was markedly higher among HS patients having Crohn's disease (CD) (3.68%), compared to HS patients without CD (0.12%). Odds of having PG was 21.14 (95% CI 17.51-25.51) times greater among HS patients compared to patients without HS. HS patients with CD had 12.38 (95% CI 9.15-16.74) times the odds of having PG compared to non-HS patients with CD. Among patients without CD, those with HS had 26.51 (95% CI 21.07-33.36) times the odds of having PG compared to non-HS patients.

Limitations

We could not establish HS phenotype among those having coexistent PG, nor could we distinguish syndromic from non-syndromic cases.

Conclusion

HS patients have increased prevalence of PG, regardless of CD status. Painful ulcerations among HS patients warrant additional evaluation for PG.

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