Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany,
Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel,
Dermatology. 2021;237(3):323-329. doi: 10.1159/000512931. Epub 2021 Mar 1.
Ulcerative colitis (UC) is a well-known underlying comorbidity of pyoderma gangrenosum (PG). However, the risk conferred by UC for the subsequent development of PG is yet to be elucidated. We aimed to estimate the magnitude of the association between UC and the subsequent occurrence of PG, which would enable us to assess the odds of PG developing in individuals with a history of UC.
A population-based case-control study was conducted to compare PG patients (n = 302) and age-, sex- and ethnicity-matched control subjects (n = 1,497) regarding the presence of UC. Logistic regression models were utilized for univariate and multivariate analyses.
The prevalence of preexisting UC was greater in patients with PG than in controls (7.3 vs. 0.5%; p < 0.001). A 15-fold increase in the odds of PG in individuals with preexisting UC was observed (OR 14.62, 95% CI 6.45-33.18). The greatest risk of developing PG occurred in the first years following the diagnosis of UC (OR 35.50, 95% CI 4.35-289.60), and decreased thereafter to 10.03 (95% CI 1.83-55.03), 6.69 (95% CI 1.49-30.02), and 10.03 (95% CI 1.83-55.03) at 1-5, 5-10, and 10-15 years after the diagnosis of UC, respectively. This association retained its statistical significance following the adjustment for confounding factors (adjusted OR 10.78, 95% CI 4.55-25.52). Patients with both PG and UC were younger and had a lower prevalence of smoking than the remaining patients with PG.
UC increases the odds of developing PG by 15-fold, with the highest probability of developing PG occurring within the first year after the diagnosis of UC. Patients with UC may be advised to avoid additional precipitating factors for the development of PG.
溃疡性结肠炎（UC）是坏疽性脓皮病（PG）的已知潜在合并症。然而，UC 对 PG 后续发生的风险尚未阐明。我们旨在评估 UC 与 PG 随后发生之间的关联程度，以便能够评估患有 UC 的个体发生 PG 的可能性。
进行了一项基于人群的病例对照研究，以比较 PG 患者（n=302）和年龄、性别和种族匹配的对照组（n=1497）中是否存在 UC。使用逻辑回归模型进行单变量和多变量分析。
PG 患者中 PG 前存在 UC 的患病率高于对照组（7.3%比 0.5%；p<0.001）。在存在 UC 的个体中，PG 的发病几率增加了 15 倍（OR 14.62，95%CI 6.45-33.18）。在 UC 诊断后的最初几年，发生 PG 的风险最大（OR 35.50，95%CI 4.35-289.60），此后逐渐下降至 10.03（95%CI 1.83-55.03）、6.69（95%CI 1.49-30.02）和 10.03（95%CI 1.83-55.03）在 UC 诊断后 1-5 年、5-10 年和 10-15 年。在调整混杂因素后，这种关联仍然具有统计学意义（调整后的 OR 10.78，95%CI 4.55-25.52）。同时患有 PG 和 UC 的患者比其余仅患有 PG 的患者更年轻，且吸烟率更低。
UC 使发生 PG 的几率增加 15 倍，UC 诊断后第一年发生 PG 的可能性最高。患有 UC 的患者可能会被建议避免发生 PG 的其他诱发因素。
