Prevalence of Pathergy After Surgical Procedures in Patients with History of Pyoderma

Abstract

Abstract Background: Pathergy refers to the tendency of a cutaneous disease, such as pyoderma gangrenosum (PG), to arise or flare at sites of physical trauma. The rate of pathergy following routine surgical procedures among patients with known PG is not well described. Objective: To determine the clinical variables that predict pathergy following surgical procedures in patients with a known history of PG. Methods: A single-center retrospective chart review was performed from 2015-2021 to identify patients with history of pyoderma gangrenosum, in order to collect: demographics, history of undergoing a surgical procedure, surgical anatomical location, type of PG lesion, comorbidities, and treatments. Results: 40 patients with a history of PG were identified, 29 (72.5%) were female, and 20 (50%) were white. Of the 12 (30%) patients who underwent surgery, such as orthopedic surgery, mastectomy and other procedures, 6 (50%) developed pathergy as a post-surgical complication. Patients with history of PG developed more PG after surgery (P=0.0002). There was no association between ongoing PG-specific treatment at moment of surgery and development of pathergy (P=0.06). Conclusions: PG patients are susceptible to pathergy following procedural interventions; thus, improved understanding of specific factors associated with a higher likelihood of pathergy after surgical procedures in PG may help improve identification of these patients in an outpatient dermatologic setting.