AUTHOR=Kridin Khalaf , Ankary-Khaner Moria , Kridin Mouhammad , Cohen Arnon D. , Badarny Samih 

TITLE=Hematological malignancy-associated pyoderma gangrenosum: evaluating the magnitude of the association

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1425454

DOI=10.3389/fmed.2024.1425454

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Background</title><p>Hematologic malignancies (HMs) are well-known underlying comorbidities of pyoderma gangrenosum (PG). However, studies quantifying the likelihood of PG after HMs are yet to be performed.</p></sec><sec id="sec2"><title>Objective</title><p>To investigate the bidirectional association between PG and several HMs, namely acute leukemia, chronic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple myeloma.</p></sec><sec id="sec3"><title>Methods</title><p>A population-based retrospective cohort study was conducted to study the risk of HMs in patients with PG (<italic>n</italic> = 302) as compared to age-, sex-and ethnicity-matched control subjects (<italic>n</italic> = 1,799). A case–control design was used to estimate the likelihood of PG in individuals with a preexisting history of HMs. Adjusted hazard ratios (HRs) and adjusted odds ratios (ORs) were estimated by Cox regression and logistic regression, respectively.</p></sec><sec id="sec4"><title>Results</title><p>The prevalence of preexisting HM was higher in patients with PG than in controls (6.7% vs. 0.9%, respectively). The likelihood of having PG was significantly greater among patients with a history of HM (adjusted OR, 7.88; 95% CI, 3.85–16.15; <italic>p</italic> &lt; 0.001), particularly during the first year following the diagnosis. This association was significant for acute leukemia, chronic leukemia, non-Hodgkin lymphoma, and multiple myeloma but not for Hodgkin lymphoma. The incidence rate of HM was 3.3 (95% CI, 1.2–7.4) and 1.6 (95% CI, 0.9–2.6)/1,000 person-years among patients with PG and controls, respectively. Relative to controls, patients with PG were not more likely to develop subsequent HM (adjusted HR, 2.22; 95%CI, 0.77–6.45; <italic>p</italic> = 0.142). Compared to other patients with PG, those with HM-associated PG experienced an increased all-cause mortality rate (adjusted HR, 2.19; 95%CI, 1.09–4.40; <italic>p</italic> = 0.028).</p></sec><sec id="sec5"><title>Conclusion</title><p>HM, particularly acute leukemia and multiple myeloma, are associated with an elevated likelihood of provoking PG.</p></sec>