Treatment of Pyoderma Gangrenosum

Dermatol Clin. 2024 Apr;42(2):183-192. doi: 10.1016/j.det.2023.12.002. Epub 2023 Dec 29.

Abstract

Pyoderma gangrenosum is a rare neutrophilic dermatosis that results in painful cutaneous ulcers and is frequently associated with underlying hematologic disorders, inflammatory bowel disease, or other autoimmune disorders. Pathogenesis involves an imbalance between proinflammatory and anti-inflammatory mediators, leading to tissue damage from neutrophils. First-line treatment options with the greatest evidence include systemic corticosteroids, cyclosporine, and tumor necrosis factor alpha inhibitors. Other steroid-sparing therapies such as dapsone, mycophenolate mofetil, intravenous immunoglobulin, and targeted biologic or small molecule inhibitors also have evidence supporting their use. Wound care and management of underlying associated disorders are critical parts of the treatment regimen.

Keywords: Neutrophil; Pyoderma gangrenosum; Review; Therapy; Treatment; Ulcer.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Cyclosporine / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Pyoderma Gangrenosum* / drug therapy
  • Pyoderma Gangrenosum* / etiology
  • Pyoderma Gangrenosum* / pathology
  • Skin Ulcer*

Substances

  • Immunosuppressive Agents
  • Cyclosporine
  • Adrenal Cortex Hormones