title: Topical tacrolimus therapy for pyoderma gangrenosum.
abstract: Pyoderma gangrenosum (PG) is a type of neutrophilic disorder with a chronic clinical course. Immunosuppressive agents have been used for its management. Among them, corticosteroid is known as the most effective. However, other immunosuppressants including cyclosporine A have been selected for patients with PG who were refractory to systemic steroids. Herein we report a case of PG resistant to systemic steroids, who was successfully treated with topical tacrolimus. A fifty-four year-old male had a 14-year history of PG. In 2002, necrotic ulcers appeared on his right leg that were refractory to oral prednisolone (30 mg/day). The application of topical tacrolimus to the border of the ulcers hastened epithelization of the ulcers and allowed for reduction of the oral prednisolone. Topical tacrolimus therapy may be an effective alternative for PG when the lesion is poorly controlled by corticosteroid.
authors.affiliation: Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Chiba
authors.forename: Iwao
authors.initials: I
authors.lastname: Isomura
authors.forename: Akiko
authors.initials: A
authors.lastname: Suzuki
authors.forename: Akimichi
authors.initials: A
authors.lastname: Morita
mesh_terms: D000287:Administration, Topical; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007871:Leg Ulcer / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000175:diagnosis* / Q000188:drug therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016559:Tacrolimus / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus