title: Treatment of pyoderma gangrenosum with mycophenolate mofetil as a steroid-sparing agent.
abstract: BACKGROUND
  Mycophenolate mofetil (MMF) has enjoyed increasing popularity as an emerging immunosuppressant treatment for various autoimmune dermatologic conditions, including pyoderma gangrenosum (PG).
  
  
  OBJECTIVE
  The aim of this study was to examine the efficacy and safety of MMF as used in PG.
  
  
  METHODS
  A retrospective chart review was conducted for all patients with PG treated with MMF at our institution (Victoria, Australia) for the past 11 years (2001-2012).
  
  
  RESULTS
  We identified 26 patients, 14 female and 12 male. Nine patients (34.6%) had associated systemic conditions. All patients received prednisolone. MMF was used as a first-line steroid-sparing agent in 11 patients (42.3%), second-line in 14 (53.8%), and third-line in 1 (3.85%). The average duration of treatment was 12.1 months. Fourteen patients experienced side effects (53.8%), although most were mild (26.9%). One patient died after a sigmoid colon perforation (3.85%). Overall 22 patients demonstrated clinical improvement during MMF treatment (84.6%). Thirteen patients achieved complete ulcer healing (50%), 10 while taking MMF and 3 after ceasing it.
  
  
  CONCLUSIONS
  This is a retrospective study based on a single-center cohort.
  
  
  CONCLUSIONS
  Our experience suggests that MMF is highly efficacious in PG together with prednisolone, or as part of combination therapy with other immunosuppressants.
authors.affiliation: Department of Dermatology, St Vincent's Hospital Melbourne, Victoria, Australia. Electronic address: jane.melb@gmail.com.
authors.forename: Jane
authors.initials: J
authors.lastname: Li
authors.forename: Robert
authors.initials: R
authors.lastname: Kelly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017511:Pyoderma Gangrenosum / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014739:Victoria; D014945:Wound Healing / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D009173:Mycophenolic Acid
keywords: autoimmune disease; immunosuppression; mycophenolate mofetil; mycophenolate sodium; pyoderma gangrenosum; steroid-sparing agent; ulcers