title: Gulliver's sign: A recognizable transition from inflammatory to healing stages of pyoderma gangrenosum.
abstract: BACKGROUND
  Pyoderma gangrenosum (PG) often necessitates long-term immunosuppressant therapy. Many patients may receive treatment for longer periods and higher doses than is clinically necessary because clinicians may have difficulty differentiating between active disease and an inactive residual ulcer that is often slow to heal.
  
  
  OBJECTIVE
  Recognition of the correct point to begin tapering therapy can help reduce the risk of adverse effects associated with treatment.
  
  
  RESULTS
  This article describes Gulliver's sign, a recognizable transition in PG patients which indicates that inflammation is under control.
  
  
  CONCLUSIONS
  This sign can be used to guide the tapering of corticosteroids and other immunosuppressant therapies in the treatment of PG.
authors.affiliation: Department of Dermatology, Wake Forest School of Medicine , Winston-Salem, NC , USA and.
authors.forename: Erin T
authors.initials: ET
authors.lastname: Landis
authors.forename: Arash
authors.initials: A
authors.lastname: Taheri
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Jorizzo
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D017511:Pyoderma Gangrenosum / Q000188:drug therapy / Q000473:pathology*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000305:Adrenal Cortex Hormones; D003879:Dermatologic Agents
keywords: Epithelium; immunosuppressant; tapering; wound