title: Therapy of pyoderma gangrenosum in Germany: results of a survey among wound experts.
abstract: BACKGROUND
  There are currently no therapeutic guidelines with respect to pyoderma gangrenosum (PG).
  
  
  METHODS
  In order to systematically record currently practiced therapeutic options for PG, a questionnaire was developed and sent to experts at various German dermatology departments.
  
  
  RESULTS
  Overall, 50 fully completed questionnaires were returned to us. On average, the diagnosis of PG is made 15 times per year. Of these patients, 11.1 % receive only topical therapy; 22.7 %, exclusively systemic therapy; and 66.2 %, both topical and systemic immunomodulatory therapy. Topically, the experts most commonly use class III (78 %) and class IV corticosteroids (88 %). All experts (100 %) reported the frequent use of systemic corticosteroids in the therapy of PG patients. Cyclosporine is used in 74 %, TNF-α inhibitors in 24 %, and azathioprine or mycophenolate mofetil each in 20 % of patients. Systemic agents such as dapsone (16 %), intravenous immunoglobulins (14 %), methotrexate (6 %), cyclophosphamide (4 %), tacrolimus (4 %), and rituximab (2 %), however, are given less frequently.
  
  
  CONCLUSIONS
  Worldwide, no uniformly accepted standard is available for the treatment of patients with PG. In our survey among experts, treatment regimens currently used in Germany, and based on expert clinical experience, have now been recorded, analyzed, and benchmarked for the first time.
authors.affiliation: Department of Dermatology, Venereology and Allergology, University Medicine Göttingen.
authors.forename: Philipp
authors.initials: P
authors.lastname: Al Ghazal
authors.forename: Joachim
authors.initials: J
authors.lastname: Dissemond
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D003879:Dermatologic Agents / Q000008:administration & dosage*; D003880:Dermatology / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D017511:Pyoderma Gangrenosum / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D003879:Dermatologic Agents; D007155:Immunologic Factors