Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.
Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
Australas J Dermatol. 2021 Aug;62(3):336-341. doi: 10.1111/ajd.13631. Epub 2021 Jun 2.
The question of whether solid malignancies (SMs) are associated with pyoderma gangrenosum (PG) remains to be conclusively answered.
To evaluate the risk of SM among patients with PG and the odds of PG after a diagnosis of SM.
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.
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.
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.
实体恶性肿瘤（SM）是否与坏疽性脓皮病（PG）有关，仍有待明确回答。
评估 PG 患者发生 SM 的风险，以及 SM 诊断后发生 PG 的几率。
采用基于人群的回顾性队列研究，比较 302 例 PG 患者（n=302）和年龄、性别和种族匹配的对照组（n=1799）中 SM 的发病风险。采用病例对照设计来估计既往存在 SM 病史的患者发生 PG 的几率。
PG 患者和对照组中，既往 SM 的患病率相当（分别为 7.5%和 8.8%；P=0.490）。SM 诊断后发生 PG 的几率并无统计学差异（OR，0.85；95%CI，0.53-1.36）。PG 患者的 SM 发病率为 6.8（95%CI，3.5-12.2），对照组为 7.9（95%CI，6.1-10.1）/1000 人年。与对照组相比，PG 患者发生 SM 的风险并不更高（HR，0.86；95%CI，0.44-1.69）。PG 合并 SM 的双重诊断患者年龄更大，合并症更多，死亡率更高。
SM 与 PG 并无关联，PG 患者发生 SM 的风险也不会增加。根据本研究结果，对新诊断为 PG 的患者进行广泛筛查以寻找 SM 并无必要。
