Pyoderma gangrenosum with pulmonary involvement: a pulmonary special report and literature review. Issue 2 (1st February 2022)

• Record Type: Journal Article
• Authors: Xing, Fanfan; Chiu, Kelvin Hei-Yeung; Yang, Jin; Ye, Haiyan; Zhang, Lijun; Liu, Chenjing; Yuen, Kwok-Yung
• Is Part Of: Expert review of respiratory medicine. Volume 16:Issue 2(2022)
• Page Start: 149
• Page End: 159
• Publication Date: 2022-02-01
• Subjects: Life-threatening airway obstruction -- pyoderma gangrenosum -- tracheobronchial involvement; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Treatment -- Periodicals; 616.2005
• DOI: 10.1080/17476348.2022.2027756
• Languages: English
• ISSNs: 1747-6348

Abstract

ABSTRACT: Introduction: Pyoderma gangrenosum (PG) is the prototypical neutrophilic dermatosis, commonly associated with inflammatory bowel disease, with pulmonary involvement being the commonest extracutaneous manifestation. PG with tracheobronchial involvement may present as upper airway obstruction and can be life-threatening. Areas covered: To evaluate the clinical characteristics and predictors of PG with pulmonary involvement, we reported a case of PG with tracheobronchial involvement in China, and performed a literature retrieval on PG with pulmonary involvement. Demographic data, clinical presentations, underlying diseases, radiological and histopathological findings, treatments, and clinical outcomes were collected and subjected to statistical analysis. Forty-seven cases (including ours) were identified. Diseases associated with PG with pulmonary involvement were similar. Clinical presentation of PG with pulmonary involvement was nonspecific, with cough and dyspnea being the most common clinical symptoms, and pulmonary infiltrates and cavitation being the most common radiological signs. Further univariate analysis suggested stridor and young age ( p < 0.01) may be predictors of tracheobronchial involvement in PG. Expert opinion: PG with tracheobronchial involvement can be life-threatening, with young age and stridor being possible predictors. Therefore, prompt airway assessment and management are required in younger patients with PG with pulmonary involvement presenting with stridor.