Diagnosis and novel clinical treatment strategies for pyoderma gangrenosum

Expert Rev Clin Pharmacol. 2020 Feb;13(2):157-161. doi: 10.1080/17512433.2020.1709825. Epub 2020 Jan 6.


Introduction: Pyoderma gangrenosum (PG) is a noninfectious, reactive inflammatory neutrophilic dermatosis that is commonly associated with autoimmune and neoplastic disorders. There are emerging diagnostic tools and treatment options for PG.Area covered: The diagnosis of PG should be seriously considered when managing ulcers to avoid unnecessary medical and surgical complications with prompt and suitable treatment. There are no standardized treatment guidelines for PG, and current therapy largely depends on the severity and progression of the disease. Systemic corticosteroids, immunosuppressant therapy, and biologic agents remain mainstay therapies. In this article, we present a literature review of recent diagnostic and novel treatment options for the management of PG. The literature research considered clinical studies or scientific reviews. Studies were identified by searching electronic databases and reference lists of respective articles till August 2019.Expert opinion: The true diagnosis of PG is challenging, as there is no diagnostic gold standard. PARACELSUS is a novel diagnostic tool. Biologics and small molecules are emerging systemic therapy options that are relatively new in treatment of PG.

Keywords: Pyoderma gangrenosum; biologic agents; corticosteroids; immunosuppressants; necrotic ulcer.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Biological Factors / administration & dosage
  • Dermatologic Agents / administration & dosage*
  • Disease Progression
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Pyoderma Gangrenosum / diagnosis
  • Pyoderma Gangrenosum / drug therapy*
  • Pyoderma Gangrenosum / pathology
  • Severity of Illness Index


  • Adrenal Cortex Hormones
  • Biological Factors
  • Dermatologic Agents
  • Immunosuppressive Agents