Optimal treatment of pyoderma gangrenosum.
The optimal treatment of pyoderma gangrenosum includes a combination of local wound care and systemic medications. Oral and pulse intravenous corticosteroids have traditionally been the most commonly recommended first-line systemic therapies. Cyclosporine, with or without corticosteroids, has more recently emerged as a first-line systemic treatment. A multitude of immunosuppressive and immune-modulating medications, as well as antimicrobial agents with anti-inflammatory properties have also been widely prescribed. Often, it is difficult to achieve control of aggressive cases of pyoderma gangrenosum, necessitating administration of a combination of systemic therapies. Furthermore, patients recalcitrant to one or many medications are frequently reported. Concomitant disease, intolerance to a class of medications, and the patient's response to prior therapies can help guide a practitioner in choosing the optimal treatment of pyoderma gangrenosum.
Gettler
Samuel
S
Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
Rothe
Marti
M
Grin
Caron
C
Grant-Kels
Jane
J
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003663:Decision Trees; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D017511:Pyoderma Gangrenosum / Q000473:pathology / Q000628:therapy*
D000276:Adjuvants, Immunologic; D000305:Adrenal Cortex Hormones; D000890:Anti-Infective Agents; D007166:Immunosuppressive Agents