Pyoderma gangrenosum and peripheral arterial disease: a case series and literature review

Background Pyoderma gangrenosum (PG) is a neutrophilic dermatosis associated with systemic inflammatory diseases. Peripheral arterial disease (PAD) is a manifestation of atherosclerosis, which is a chronic inflammatory disease. Hypothesis Is the presence of PAD a risk factor for the prognosis of PG? Methods We performed a retrospective medical chart review of seven patients with an overlap of PAD and PG and compared treatment strategies and outcomes. Results Six out of seven patients had a poor outcome, requiring amputation, even though adequate treatment was initiated. Conclusions We propose that PAD, whether by reducing the healing potential or by partially contributing to the pathophysiology of the wounds, is a risk factor for the prognosis of PG. Furthermore, the fact that three of the patients developed PAD within a very short period of time after the diagnosis of PG suggests that PG could itself be a risk factor for the development of PAD. However, more clinical data is required to adequately assess this possible relation. Implications for clinical practice Raise awareness to the possible co-existency of both diagnoses and the importance of early screening.