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Monoclonal gammopathy in the setting of Pyoderma gangrenosum

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Abstract

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterized by ulcerative painful lesions with violaceous undermined borders. Up to 75% of PG cases develop in association with an underlying systemic disease. Monoclonal gammopathy is reportedly a concomitant condition with PG, with studies indicating immunoglobulin (Ig) A gammopathy as the most common. Whether gammopathy is associated with PG or is an incidental finding has been debated. We sought to investigate the association and characteristics of gammopathy in patients with PG. We retrospectively identified PG patients at our institution from 2010 to 2022 who were screened for plasma cell dyscrasia. Of 106 patients identified, 29 (27%) had a gammopathy; subtypes included IgA (41%), IgG (28%), and biclonal (IgA and IgG) (14%). Mean age was similar between those with and without gammopathy (60.7 vs. 55.9 years; P = .26). In addition, hematologic or solid organ cancer developed in significantly more patients with vs. without gammopathy (8/29 [28%] vs. 5/77 [6%]; P = .003). Among the subtypes of gammopathy, IgG monoclonal gammopathy had the highest proportion of patients with subsequent cancer development (4 of 8 patients, 50%). Study limitations include a retrospective, single-institution design with a limited number of patients. Overall, our data show a high prevalence of gammopathy in patients with PG; those patients additionally had an increased incidence of cancer, especially hematologic cancer.

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Data availability

No datasets were generated or analysed during the current study.

Code availability

Not applicable

Abbreviations

Ig:

Immunoglobulin

MDS:

Myelodysplastic syndromes

MG:

Monoclonal gammopathy

MGUS:

Monoclonal gammopathy of uncertain significance

PG:

Pyoderma gangrenosum

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Acknowledgements

The Scientific Publications staff at Mayo Clinic provided editorial consultation, proofreading, and administrative and clerical support.

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Authors and Affiliations

  1. Department of Dermatology, Mayo Clinic, Rochester, MN, Canada

    Vahide Saeidi, Vishal Garimella, David A. Wetter, Mark Denis P. Davis & Afsaneh Alavi

  2. Department of Hematology, Mayo Clinic, Rochester, MN, USA

    Kumar Shaji

  3. Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA

    Austin Todd

  4. Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada

    Jan Dutz

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  1. Vahide Saeidi
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Contributions

V.S. data extraction, review the data, draft the paperV. G. data extraction, review the data, draft the paper S. K. review of the paper D. A. W. review of the paperM. D. P. D. review of the paperA. T. statisticsJ. D. review the paperA. A. study design, review the data, major contribution in the manuscript, review the final draft.

Corresponding author

Correspondence to Afsaneh Alavi.

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Saeidi, V., Garimella, V., Shaji, K. et al. Monoclonal gammopathy in the setting of Pyoderma gangrenosum. Arch Dermatol Res 316, 268 (2024). https://doi.org/10.1007/s00403-024-03098-7

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  • DOI: https://doi.org/10.1007/s00403-024-03098-7

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