{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:52:08Z","timestamp":1791179528877,"version":"4.1.0"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:sec id=\"ab-doi220063-4\"><jats:title>Importance<\/jats:title><jats:p>Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis. Few studies have evaluated the mortality outcomes of patients with PG.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220063-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate all-cause and cause-specific mortality in patients with PG.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220063-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective population-based cohort study used data from the National Health Insurance Service database of Korea and the National Death Registry of Korea from patients with incident PG (\u22653 documented visits with an <jats:italic>International Statistical Classification of Diseases and Related Health Problems, Tenth Revision <\/jats:italic>[<jats:italic>ICD-10<\/jats:italic>] code of L88) during January 2003 to December 2019. For comparison, a 1:20 cohort of age-, sex-, insurance type\u2013, and income level\u2013matched controls without any documented visit with an <jats:italic>ICD-10<\/jats:italic> code of L88 during the entire observation was included.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220063-7\"><jats:title>Exposures<\/jats:title><jats:p>Pyoderma gangrenosum.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220063-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The participants were observed from the index date to their death, emigration, or the end of the observation period to investigate all-cause and cause-specific mortality during the 17-year study period.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220063-9\"><jats:title>Results<\/jats:title><jats:p>In total, 3386 patients with PG (1450 women [42.8%]; mean [SD] age, 57.8 [16.4] years) and 67\u202f720 controls (29\u202f000 women [42.8%]; mean [SD] age, 57.8 [16.3] years) were analyzed. All-cause mortality risk was greater in patients with PG than in controls (adjusted hazard ratio [aHR], 2.122; 95% CI, 1.971-2.285) after adjustment for smoking, drinking, body mass index, and comorbidities. Patients experienced greater mortality of infectious disease (aHR, 3.855; 95% CI, 2.640-5.628), neoplasm (aHR, 1.618; 95% CI, 1.363-1.920), hematologic disease (aHR, 12.298; 95% CI, 3.904-38.734), endocrine disease (aHR, 6.322; 95% CI, 5.026-7.953), neurologic disease (aHR, 2.039; 95% CI, 1.337-3.109), cardiovascular disease (aHR, 1.979; 95% CI, 1.645-2.382), respiratory disease (aHR, 1.757; 95% CI, 1.365-2.263), gastrointestinal disease (aHR, 2.278; 95% CI, 1.522-3.408), connective tissue disease (aHR, 8.685; 95% CI, 4.963-15.199), and kidney\/urogenital disease (aHR, 3.617; 95% CI, 2.488-5.259) than controls. Compared with idiopathic PG (aHR, 2.062; 95% CI, 1.897-2.241), PG that was associated with solid organ cancer (aHR, 2.313; 95% CI, 1.956-2.737) and hematologic cancer (aHR, 8.330; 95% CI, 5.473-12.679) showed greater mortality, whereas PG that was associated with inflammatory bowel diseases showed a slightly better prognosis (aHR, 1.742; 95% CI, 0.964-3.148).<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi220063-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>The results of this cohort study suggest that patients with PG had a higher all-cause and cause-specific mortality risk than the general population.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2022.5437","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T16:08:53Z","timestamp":1671638933000},"page":"151","source":"Crossref","is-referenced-by-count":24,"title":["Association of All-Cause and Cause-Specific Mortality Risks With Pyoderma Gangrenosum"],"prefix":"10.1001","volume":"159","author":[{"given":"Solam","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea"},{"name":"Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju Yeong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Jeong","family":"Ju","sequence":"additional","affiliation":[{"name":"Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Baek","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Min","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju Hee","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"doi220063r1","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1001\/jamadermatol.2017.5978","article-title":"The association of age with clinical presentation and comorbidities of pyoderma gangrenosum.","volume":"154","author":"Ashchyan","year":"2018","journal-title":"JAMA Dermatol"},{"issue":"4","key":"doi220063r2","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1016\/j.jaad.2015.06.021","article-title":"Pathophysiology of pyoderma gangrenosum (PG): an updated review.","volume":"73","author":"Braswell","year":"2015","journal-title":"J Am Acad Dermatol"},{"issue":"1","key":"doi220063r3","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1038\/s41572-020-0213-x","article-title":"Pyoderma gangrenosum.","volume":"6","author":"Maverakis","year":"2020","journal-title":"Nat Rev Dis Primers"},{"issue":"1","key":"doi220063r4","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1111\/bjd.16463","article-title":"Comorbidities of pyoderma gangrenosum: a retrospective multicentric analysis of 126 patients.","volume":"179","author":"Gillard","year":"2018","journal-title":"Br J Dermatol"},{"key":"doi220063r5","doi-asserted-by":"publisher","first-page":"b5087","DOI":"10.1136\/bmj.b5087","article-title":"Problem of immortal time bias in cohort studies: example using statins for preventing progression of diabetes.","volume":"340","author":"L\u00e9vesque","year":"2010","journal-title":"BMJ"},{"issue":"6","key":"doi220063r6","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1016\/j.jaad.2017.11.063","article-title":"Neutrophilic dermatoses: pyoderma gangrenosum and other bowel- and arthritis-associated neutrophilic dermatoses.","volume":"79","author":"Ashchyan","year":"2018","journal-title":"J Am Acad Dermatol"},{"issue":"2","key":"doi220063r7","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1001\/jamadermatol.2021.5001","article-title":"Pyoderma gangrenosum.","volume":"158","author":"Hou","year":"2022","journal-title":"JAMA Dermatol"},{"issue":"6","key":"doi220063r8","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1111\/bjd.2011.165.issue-6","article-title":"Pyoderma gangrenosum: a retrospective review of patient characteristics, comorbidities and therapy in 103 patients.","volume":"165","author":"Binus","year":"2011","journal-title":"Br J Dermatol"},{"issue":"3","key":"doi220063r9","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1111\/j.1440-0960.2011.00750.x","article-title":"Pyoderma gangrenosum requiring inpatient management: a report of 26 cases with follow up.","volume":"52","author":"Saracino","year":"2011","journal-title":"Australas J Dermatol"},{"issue":"9","key":"doi220063r10","doi-asserted-by":"publisher","first-page":"2166","DOI":"10.1038\/jid.2012.130","article-title":"Incidence, mortality, and disease associations of pyoderma gangrenosum in the United Kingdom: a retrospective cohort study.","volume":"132","author":"Langan","year":"2012","journal-title":"J Invest Dermatol"},{"issue":"6","key":"doi220063r11","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1111\/bjd.v185.6","article-title":"Comorbidities, mortality and survival in patients with pyoderma gangrenosum: a Danish nationwide registry-nested case-control study.","volume":"185","author":"Ben Abdallah","year":"2021","journal-title":"Br J Dermatol"},{"key":"doi220063r12","doi-asserted-by":"publisher","DOI":"10.1007\/s00403-021-02278-z","article-title":"Diagnostic work-up and treatment in patients with pyoderma gangrenosum: retrospective analysis of US insurance claims-based data.","author":"Shaigany","year":"2021","journal-title":"Arch Dermatol Res"},{"issue":"4","key":"doi220063r13","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1016\/j.cpm.2021.06.002","article-title":"Pyoderma gangrenosum: a literature review.","volume":"38","author":"Barbe","year":"2021","journal-title":"Clin Podiatr Med Surg"},{"issue":"3","key":"doi220063r14","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1007\/s40257-017-0251-7","article-title":"Pyoderma gangrenosum: an update on pathophysiology, diagnosis and treatment.","volume":"18","author":"Alavi","year":"2017","journal-title":"Am J Clin Dermatol"},{"issue":"3","key":"doi220063r15","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1111\/ajd.v62.3","article-title":"Is pyoderma gangrenosum associated with solid malignancies? insights from a population-based cohort study.","volume":"62","author":"Kridin","year":"2021","journal-title":"Australas J Dermatol"},{"issue":"9","key":"doi220063r16","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1111\/jdv.2009.23.issue-9","article-title":"Pyoderma gangrenosum: an updated review.","volume":"23","author":"Ruocco","year":"2009","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"4","key":"doi220063r17","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1007\/s00403-020-02098-7","article-title":"The inpatient burden and comorbidities of pyoderma gangrenosum in adults in the United States.","volume":"313","author":"Narla","year":"2021","journal-title":"Arch Dermatol Res"},{"issue":"5","key":"doi220063r18","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/j.clindermatol.2015.05.003","article-title":"Pyoderma gangrenosum\u2014a systemic disease?","volume":"33","author":"Wollina","year":"2015","journal-title":"Clin Dermatol"},{"key":"doi220063r19","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/1750-1172-8-136","article-title":"Associated factors and comorbidities in patients with pyoderma gangrenosum in Germany: a retrospective multicentric analysis in 259 patients.","volume":"8","author":"Al Ghazal","year":"2013","journal-title":"Orphanet J Rare Dis"},{"issue":"5","key":"doi220063r20","doi-asserted-by":"publisher","first-page":"345","DOI":"10.2310\/7750.2013.13177","article-title":"Trends in the association between pyoderma gangrenosum and autoimmune hepatitis: case report and review of the literature.","volume":"18","author":"Wat","year":"2014","journal-title":"J Cutan Med Surg"},{"key":"doi220063r21","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1186\/s12876-015-0376-1","article-title":"A case report of successful treatment of pyoderma gangrenosum in a patient with autoimmune hepatitis, and review of the literature.","volume":"15","author":"Androutsakos","year":"2015","journal-title":"BMC Gastroenterol"},{"issue":"3","key":"doi220063r22","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1111\/bjd.13955","article-title":"Pyoderma gangrenosum and Sweet syndrome: the prototypic neutrophilic dermatoses.","volume":"178","author":"Wallach","year":"2018","journal-title":"Br J Dermatol"},{"key":"doi220063r23","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/bs.acc.2020.06.004","article-title":"Cytokines and the immune response in obesity-related disorders.","volume":"101","author":"Moghbeli","year":"2021","journal-title":"Adv Clin Chem"},{"issue":"5","key":"doi220063r24","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1111\/bjd.2016.175.issue-5","article-title":"Pyoderma gangrenosum and its syndromic forms: evidence for a link with autoinflammation.","volume":"175","author":"Marzano","year":"2016","journal-title":"Br J Dermatol"},{"issue":"19","key":"doi220063r25","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-3671","article-title":"Pyoderma gangrenosum revealing myeloid activation of Fanconi anaemia: two case reports.","volume":"100","author":"Mokrzycki","year":"2020","journal-title":"Acta Derm Venereol"},{"key":"doi220063r26","doi-asserted-by":"publisher","DOI":"10.1136\/jmg-2022-108655","article-title":"A digital pathway for genetic testing in UK NHS patients with cancer: BRCA-DIRECT randomised study internal pilot.","author":"Torr","year":"2022","journal-title":"J Med Genet"},{"issue":"2","key":"doi220063r27","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1111\/ijd.v59.2","article-title":"Paraneoplastic pyoderma gangrenosum in solid organ malignancy: a literature review.","volume":"59","author":"Shah","year":"2020","journal-title":"Int J Dermatol"},{"issue":"9","key":"doi220063r28","doi-asserted-by":"publisher","first-page":"1873","DOI":"10.1016\/j.jid.2019.12.040","article-title":"Next-generation sequencing in myeloid neoplasm-associated Sweet\u2019s syndrome demonstrates clonal relation between malignant cells and skin-infiltrating neutrophils.","volume":"140","author":"Passet","year":"2020","journal-title":"J Invest Dermatol"},{"issue":"3","key":"doi220063r29","doi-asserted-by":"publisher","first-page":"224","DOI":"10.7861\/clinmedicine.19-3-224","article-title":"Pyoderma gangrenosum\u2014a guide to diagnosis and management.","volume":"19","author":"George","year":"2019","journal-title":"Clin Med (Lond)"},{"issue":"10","key":"doi220063r30","doi-asserted-by":"publisher","first-page":"E693","DOI":"10.1111\/ans.2018.88.issue-10","article-title":"Peristomal pyoderma gangrenosum: 12-year experience in a single tertiary referral centre.","volume":"88","author":"Toh","year":"2018","journal-title":"ANZ J Surg"},{"issue":"4","key":"doi220063r31","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-3776","article-title":"Pyoderma gangrenosum: a retrospective study of clinical characteristics, comorbidities, response to treatment and mortality related to prednisone dose.","volume":"101","author":"Sch\u00f8sler","year":"2021","journal-title":"Acta Derm Venereol"},{"issue":"4","key":"doi220063r32","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1159\/000481432","article-title":"Clinical disease patterns in a regional Swiss cohort of 34 pyoderma gangrenosum patients.","volume":"233","author":"Kolios","year":"2017","journal-title":"Dermatology"},{"issue":"6","key":"doi220063r33","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9061626","article-title":"Is gout associated with pyoderma gangrenosum? a population-based case-control study.","volume":"9","author":"Kridin","year":"2020","journal-title":"J Clin Med"},{"issue":"6","key":"doi220063r34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/01.ASW.0000661796.90753.f3","article-title":"Pyoderma gangrenosum and superimposed infection: a case report.","volume":"33","author":"Gavioli","year":"2020","journal-title":"Adv Skin Wound Care"},{"issue":"2","key":"doi220063r35","doi-asserted-by":"publisher","first-page":"e46","DOI":"10.1111\/ajd.2016.57.issue-2","article-title":"Concurrent pyoderma gangrenosum and infection with Scedosporium apiospermum.","volume":"57","author":"Tilakaratne","year":"2016","journal-title":"Australas J Dermatol"},{"issue":"3","key":"doi220063r36","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1177\/1534734617710980","article-title":"Pyoderma gangrenosum: a current problem as much as an unknown one.","volume":"16","author":"Vallini","year":"2017","journal-title":"Int J Low Extrem Wounds"},{"issue":"Sup1","key":"doi220063r37","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.12968\/jowc.2018.27.Sup1.S4","article-title":"Pyoderma gangrenosum demographics, treatments, and outcomes: an analysis of 2,273 cases.","volume":"27","author":"Sasor","year":"2018","journal-title":"J Wound Care"}],"container-title":["JAMA Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/articlepdf\/2799535\/jamadermatology_lee_2022_oi_220063_1675100226.64613.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T16:05:45Z","timestamp":1676477145000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/fullarticle\/2799535"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,1]]},"references-count":37,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamadermatol.2022.5437","relation":{},"ISSN":["2168-6068"],"issn-type":[{"value":"2168-6068","type":"print"}],"subject":[],"published":{"date-parts":[[2023,2,1]]}}}