BACKGROUND Pyoderma gangrenosum (PG) is an uncommon but severe extra-intestinal manifestation (EIM) of inflammatory bowel disease (IBD). The incidence and risk factors for PG are disputed. AIMS To assess the incidence of PG and identify factors associated with PG in IBD patients. METHODS A search of electronic databases (Ovid and PubMed) was conducted between 1966 and 2019. Studies that calculated the incidence of PG in IBD patient cohorts were included. Patient demographics, IBD subtype, and EIM presence were recorded. A review of our institutional database of 1057 IBD patients was conducted. A multivariate regression model and meta-analysis were conducted to identify risk factors for PG. A random effects model was used to combine the data of included studies. RESULTS Fourteen studies were included in addition to 1057 IBD patients and 26 PG cases from the Louisville cohort. In total, there were 379 cases of PG in the cumulative cohort of 61,695 IBD patients. The PG incidence in individual studies ranged from 0.4 to 2.6%. In the institutional cohort, ocular EIMs and a permanent stoma were significant risk factors for PG. In the meta-analysis, PG was associated with female gender (RR = 1.328, 95% CI 1.161-1.520), Crohn's disease (RR = 1.193, 95% CI 1.001-1.422), erythema nodosum (RR = 9.281, 95% CI 6.081-14.164), and ocular EIM (RR = 4.55, 95% CI 3.04-6.81). There was study heterogeneity when assessing IBD subtype, ocular, and joint EIMs. CONCLUSIONS There are conflicting data on the incidence and risk factors for PG. This meta-analysis confirms an association between PG and female gender, Crohn's disease, erythema nodosum, and ocular EIM that have been described in smaller studies.

中文翻译：

---

炎症性肠病中的坏疽性脓皮病：系统评价和荟萃分析。

背景坏疽性脓皮病 (PG) 是炎症性肠病 (IBD) 的一种罕见但严重的肠外表现 (EIM)。PG 的发病率和危险因素存在争议。目的 评估 IBD 患者 PG 的发生率并确定与 PG 相关的因素。方法 在 1966 年至 2019 年期间对电子数据库（Ovid 和 PubMed）进行了搜索。纳入了计算 IBD 患者队列中 PG 发病率的研究。记录患者人口统计学、IBD 亚型和 EIM 存在。我们对 1057 名 IBD 患者的机构数据库进行了审查。进行多变量回归模型和荟萃分析以确定 PG 的危险因素。采用随机效应模型对纳入研究的数据进行合并。结果 除了来自路易斯维尔队列的 1057 名 IBD 患者和 26 名 PG 病例外，还包括 14 项研究。在 61,695 名 IBD 患者的累积队列中，总共有 379 例 PG。个别研究中的 PG 发生率为 0.4% 至 2.6%。在机构队列中，眼 EIM 和永久性造口是 PG 的重要危险因素。在荟萃分析中，PG 与女性（RR = 1.328, 95% CI 1.161-1.520）、克罗恩病（RR = 1.193, 95% CI 1.001-1.422）、结节性红斑（RR = 9.281, 95% CI 6.081-14.164）和眼 EIM（RR = 4.55，95% CI 3.04-6.81）。在评估 IBD 亚型、眼部和关节 EIM 时存在研究异质性。结论 关于 PG 的发病率和危险因素存在相互矛盾的数据。这项荟萃分析证实了 PG 与女性性别之间的关联，