Chlorambucil--an effective corticosteroid-sparing therapy for pyoderma gangrenosum.
A 21-year-old man, with a past history of severe aphthosis and arthritis between age 5 and 15 years, presented at age 18 years with a large leg ulceration, which developed after minor trauma. At that time he was otherwise healthy and taking no medications. Between 1983 and 1986 the patient failed to respond to intensive topical care to the ulcer, two attempted skin grafts, oral prednisone (up to 200 mg/day), sulfasalazine, dapsone (200 mg/day), multiple trials of intralesional triamcinolone acetonide, hyperbaric oxygen, azathioprine, methotrexate, clofazimine, minocycline, and three courses of pulse methylprednisolone therapy. Therapy with chlorambucil (4 mg/day) resulted in progressive improvement and complete healing with eventual cessation of all other therapy. The use of chlorambucil in pyoderma gangrenosum may be an effective adjunctive steroid-sparing therapy.
Department of Medicine, University of Louisville, Ky.
J P
JP
Callen
J D
JD
Case
D
D
Sager
D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D002699:Chlorambucil / Q000008:administration & dosage / Q000627:therapeutic use*; D005734:Gangrene; D006801:Humans; D007871:Leg Ulcer / Q000188:drug therapy*; D008297:Male; D011711:Pyoderma / Q000188:drug therapy* / Q000473:pathology
D000305:Adrenal Cortex Hormones; D002699:Chlorambucil