Retrospective analysis of comprehensive nursing care management in pyoderma gangrenosum: Case series and literature review

坏疽性脓皮病综合护理管理的回顾性分析:病例系列及文献综述

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Abstract

RATIONALE: Pyoderma gangrenosum (PG), a rare immune-mediated dermatosis characterized by painful, necrotic, and rapidly progressive ulcers, is often associated with systemic diseases such as inflammatory bowel disease and rheumatoid arthritis, posing significant clinical management challenges. This study aimed to evaluate the efficacy of comprehensive nursing strategies for PG patients through retrospective analysis, summarize clinical nursing experiences, and provide references for improving patient outcomes. PATIENT CONCERNS: Clinical data from 7 PG patients admitted to Beijing Chaoyang Hospital, Capital Medical University, between January 2014 and December 2024 were retrospectively analyzed. DIAGNOSES: Seven cases were diagnosed with PG according to the Delphi expert consensus criteria. INTERVENTIONS: All patients received systemic immunosuppressive therapy (primarily glucocorticoids, with some combined with immunosuppressants) and multidimensional nursing interventions (including ward management, wound care, pain control, comorbidity monitoring, psychological care, and health education). OUTCOMES: Following systemic treatment and comprehensive nursing, all 7 patients achieved significant ulcer healing. The average pain score decreased from 7.86 ± 1.07 at admission to 0.86 ± 0.90 at discharge, with no severe complications reported. Individualized wound management (e.g., topical triethanolamine cream) and strict infection control were critical to therapeutic success. However, 2 cases developed secondary infections due to suboptimal ward isolation. LESSONS: Within the limitations of this small retrospective case series, our findings suggest that multidimensional comprehensive nursing interventions may serve as a beneficial adjunct to systemic medical therapy for PG patients, potentially contributing to wound healing, pain alleviation, and complication reduction. However, the observed outcomes cannot be definitively attributed solely to nursing care due to the lack of a control group. Future prospective, multicenter, and controlled studies with larger cohorts are essential to validate the efficacy and cost-effectiveness of these comprehensive nursing strategies. Nonetheless, optimizing protective isolation measures remains a critical practical consideration to mitigate infection risk in these vulnerable patients.

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