Materiały źródłowe

• #1 Pyoderma Gangrenosum: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17825-pyoderma-gangrenosum-pg

  Medical experts arent sure exactly what causes pyoderma gangrenosum, so there may be no way to prevent it. […] If you have any risk factors associated with pyoderma gangrenosum, such as leukemia or inflammatory bowel disease, be sure to let your healthcare provider know right away if you develop any skin problems. Ask your healthcare provider to refer a dermatologist or another specialist with experience in treating pyoderma gangrenosum. […] Early diagnosis and treatment are important in preventing scars.

• #1 Pyoderma gangrenosum | Altru Health System

  https://www.altru.org/health-library/conditions/pyoderma-gangrenosum

  You can’t prevent the first instance of pyoderma gangrenosum. If you have the condition, you can help prevent new sores by protecting your skin from injury. Injury or trauma to the skin, including from surgery, can cause new sores to form. […] It also may help to control any other condition you have that’s related to pyoderma gangrenosum.

• #2 Pyoderma gangrenosum | Altru Health System

  https://www.altru.org/health-library/conditions/pyoderma-gangrenosum

  You can’t prevent the first instance of pyoderma gangrenosum. If you have the condition, you can help prevent new sores by protecting your skin from injury. Injury or trauma to the skin, including from surgery, can cause new sores to form. […] It also may help to control any other condition you have that’s related to pyoderma gangrenosum.

• #2 Pyoderma gangrenosum – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/pyoderma-gangrenosum/

  You can’t totally prevent pyoderma gangrenosum. If you have the condition, try to avoid injuring your skin. Injury or trauma to your skin, including from surgery, can provoke new ulcers to form. It may also help to control any underlying condition that may be causing the ulcers.

• #3 Pyoderma gangrenosum – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/pyoderma-gangrenosum/

  You can’t totally prevent pyoderma gangrenosum. If you have the condition, try to avoid injuring your skin. Injury or trauma to your skin, including from surgery, can provoke new ulcers to form. It may also help to control any underlying condition that may be causing the ulcers.

• #3 Treatment of Peristomal Pyoderma Gangrenosum With Topical Crushed Dapsone – JDDonline – Journal of Drugs in Dermatology

  https://jddonline.com/articles/treatment-of-peristomal-pyoderma-gangrenosum-with-topical-crushed-dapsone-S1545961611P1059X

  Controlling the underlying disease is the initial step in treatment. […] Wound care is important to prevent bacterial infection at the site. Maintenance of clean, dry, dressings decreases risk of infection at ulcer sites.

• #4 Causes, Symptoms & Treatment of Pyoderma Gangrenosum

  https://legsmatter.org/information-and-support/skin-concerns/pyoderma-gangrenosum/

  The Dermatologist will be able to advise on the risk of recurrence and this will be related to the cause, whether it was spontaneous and how well the ulceration responded to the medication. […] It is recommended to keep wearing compression socks to support the leg and reduce the risk of recurrence, especially if there was significant lower leg swelling.

• #5 Pyoderma Gangrenosum: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17825-pyoderma-gangrenosum-pg

  Medical experts arent sure exactly what causes pyoderma gangrenosum, so there may be no way to prevent it. […] If you have any risk factors associated with pyoderma gangrenosum, such as leukemia or inflammatory bowel disease, be sure to let your healthcare provider know right away if you develop any skin problems. Ask your healthcare provider to refer a dermatologist or another specialist with experience in treating pyoderma gangrenosum. […] Early diagnosis and treatment are important in preventing scars.

• #6 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  It is essential to exclude other diagnoses such as infectious diseases before therapy is initiated as corticosteroid and immunosuppressant therapy is the mainstay in the treatment of PG. […] The treatment of the underlying disease may aid in healing the ulcer. […] In patients without an identifiable associated disease, it is still possible for it to appear later; hence evaluation is indicated even after the skin lesions have healed. […] Local therapy is an important adjunct to systemic therapy and may provide relief from symptoms. […] Gentle debridement of the ulcer can be done with Burrows solution, silver nitrate or potassium permanganate baths. […] Aggressive surgical debridement or skin grafting is discouraged because of the risk of a pathergic response. […] However, skin grafting may be successful if systemic steroid cover is given during the procedure and until both the graft and donor sites have healed.

• #7 Topical Therapy for Pyoderma Gangrenosum Safe, Effective | Skin and Cancer Associates – Hallandale Beach

  https://dermatologyhallandale.com/2019/01/24/topical-therapy-for-pyoderma-gangrenosum-safe-effective/

  The use of high-potency topical corticosteroid therapy in patients with pyoderma gangrenosum (PG) is an effective first-line treatment that avoids the possible adverse effects associated with the use of systemic therapies, according to the results of a recent study. […] Overall, 43.8% of the participants healed with the use of topical therapy alone within the 6-month treatment period. […] The investigators concluded that clobetasol propionate 0.05% demonstrated potential use as a first-line treatment for patients with PG, particularly those with small lesions. […] Whether more severe PG will respond adequately to topical treatment alone requires further elucidation, with larger ulcerations possibly requiring more intensive therapy.

• #8 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  Various agents that have been used for local therapy include topical and intralesional corticosteroids, topical 5-aminosalicylic acid, benzoyl peroxide, topical sodium cromoglycate, intralesional cyclosporine and topical nitrogen mustard. […] For early and localized lesions, intralesional corticosteroid injections with triamcinolone acetonide may halt progression and induce healing. […] Caution must be exercised to avoid introducing infection and interfering with healing through overly aggressive injections. […] Topical tacrolimus (0.5% solution) can be used as an add-on and follow-up medication in the treatment of PG. […] Systemic corticosteroids are considered as the drug of choice for the treatment of PG and are particularly effective in treating the acute, rapidly progressive form of this disease.

• #9 Topical treatment of pyoderma gangrenosum: A systematic review – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/topical-treatment-of-pyoderma-gangrenosum-a-systematic-review/

  The most widely used topical treatments for PG are corticosteroids and calcineurin inhibitors. The available evidence suggests that they are likely to have similar efficacy and are generally well tolerated. […] In patients with idiopathic PG and small, early-onset lesions, there may be a greater role for topical monotherapy. For these patients, early intervention with topical treatment may present a preferable treatment option to prolonged therapy with systemic immunosuppression.

• #10 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  Various agents that have been used for local therapy include topical and intralesional corticosteroids, topical 5-aminosalicylic acid, benzoyl peroxide, topical sodium cromoglycate, intralesional cyclosporine and topical nitrogen mustard. […] For early and localized lesions, intralesional corticosteroid injections with triamcinolone acetonide may halt progression and induce healing. […] Caution must be exercised to avoid introducing infection and interfering with healing through overly aggressive injections. […] Topical tacrolimus (0.5% solution) can be used as an add-on and follow-up medication in the treatment of PG. […] Systemic corticosteroids are considered as the drug of choice for the treatment of PG and are particularly effective in treating the acute, rapidly progressive form of this disease.

• #11 Topical treatment of pyoderma gangrenosum: A systematic review – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/topical-treatment-of-pyoderma-gangrenosum-a-systematic-review/

  The primary objectives of this review were to assess the efficacy, safety, and evidence supporting the use of topical treatments for PG. […] The available evidence suggests that systemic treatments are most effective. As such, a randomised controlled trial comparing topical monotherapy with systemic treatments would be challenging to design, both ethically and logistically. […] An interesting point raised in our review, albeit one highlighted by a small case series, is that topical treatment could present an appealing first-line option in patients with newly diagnosed PG that is not associated with systemic disease. Current practice tends towards swift treatment with systemic corticosteroids in such patients, but further investigation into the efficacy of topical treatment for early, idiopathic, and mild PG could be logical based on the findings of this review.

• #12 Topical treatment of pyoderma gangrenosum: A systematic review – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/topical-treatment-of-pyoderma-gangrenosum-a-systematic-review/

  The most widely used topical treatments for PG are corticosteroids and calcineurin inhibitors. The available evidence suggests that they are likely to have similar efficacy and are generally well tolerated. […] In patients with idiopathic PG and small, early-onset lesions, there may be a greater role for topical monotherapy. For these patients, early intervention with topical treatment may present a preferable treatment option to prolonged therapy with systemic immunosuppression.

• #13 Treatment-resistant pyoderma gangrenosum managed with maggot debridement therapy and hyperbaric oxygen therapy: a case study – Wounds UK

  https://wounds-uk.com/journal-articles/treatment-resistant-pyoderma-gangrenosum-managed-with-maggot-debridement-therapy-and-hyperbaric-oxygen-therapy-a-case-study/

  Ongoing immunosuppression is essential to ensure the switching off of the immune process and treat the pyoderma gangrenosum. […] The treatment of pyoderma gangrenosum can be challenging. There are no standardised guidelines, furthermore, management is largely based on case reports and case series. The main goal is immunosuppression leading to wound healing, noting that comorbidities such as diabetes or peripheral vascular disease may prolong and adversely affect healing. […] Wound care is an important aspect of pyoderma gangrenosum management and debridement of non-viable tissue may be required. Debridement strategies in chronic wound care are well established and are most commonly surgical, autolytic, osmotic or maggot debridement therapy types. […] HBOT is a process of supplying tissue with oxygen to promote healing. Wounds, such as in pyoderma gangrenosum, are starved of oxygen and therefore healing is diminished.

• #14 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  Various agents that have been used for local therapy include topical and intralesional corticosteroids, topical 5-aminosalicylic acid, benzoyl peroxide, topical sodium cromoglycate, intralesional cyclosporine and topical nitrogen mustard. […] For early and localized lesions, intralesional corticosteroid injections with triamcinolone acetonide may halt progression and induce healing. […] Caution must be exercised to avoid introducing infection and interfering with healing through overly aggressive injections. […] Topical tacrolimus (0.5% solution) can be used as an add-on and follow-up medication in the treatment of PG. […] Systemic corticosteroids are considered as the drug of choice for the treatment of PG and are particularly effective in treating the acute, rapidly progressive form of this disease.

• #15 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  The potential for sudden electrolyte shifts with subsequent cardiac arrhythmias indicates that pulse therapy should be used only in selected patients whose disease is resistant to other forms of therapy. […] Immunosuppressive agents like azathioprine, mercaptopurine, cyclophosphamide, arabinoside, chlorambucil, colchicine and daunorubicin have been used as an adjunctive or alternative therapy to systemic corticosteroids with varying success in PG. […] Cyclosporine, which does not cause significant myelosuppression, is one of the most promising immunosuppressants for the treatment of PG. […] Tacrolimus, a novel macrolide antibiotic with immunosuppressive properties, has recently been used as a steroid-sparing or replacing agent in the treatment of PG. […] Mycophenolate mofetil has been found useful as a relatively well tolerated immunosuppressive agent in various immune-mediated inflammatory dermatological diseases including PG.

• #16 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  The potential for sudden electrolyte shifts with subsequent cardiac arrhythmias indicates that pulse therapy should be used only in selected patients whose disease is resistant to other forms of therapy. […] Immunosuppressive agents like azathioprine, mercaptopurine, cyclophosphamide, arabinoside, chlorambucil, colchicine and daunorubicin have been used as an adjunctive or alternative therapy to systemic corticosteroids with varying success in PG. […] Cyclosporine, which does not cause significant myelosuppression, is one of the most promising immunosuppressants for the treatment of PG. […] Tacrolimus, a novel macrolide antibiotic with immunosuppressive properties, has recently been used as a steroid-sparing or replacing agent in the treatment of PG. […] Mycophenolate mofetil has been found useful as a relatively well tolerated immunosuppressive agent in various immune-mediated inflammatory dermatological diseases including PG.

• #17 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  The potential for sudden electrolyte shifts with subsequent cardiac arrhythmias indicates that pulse therapy should be used only in selected patients whose disease is resistant to other forms of therapy. […] Immunosuppressive agents like azathioprine, mercaptopurine, cyclophosphamide, arabinoside, chlorambucil, colchicine and daunorubicin have been used as an adjunctive or alternative therapy to systemic corticosteroids with varying success in PG. […] Cyclosporine, which does not cause significant myelosuppression, is one of the most promising immunosuppressants for the treatment of PG. […] Tacrolimus, a novel macrolide antibiotic with immunosuppressive properties, has recently been used as a steroid-sparing or replacing agent in the treatment of PG. […] Mycophenolate mofetil has been found useful as a relatively well tolerated immunosuppressive agent in various immune-mediated inflammatory dermatological diseases including PG.

• #18 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  Recently, infliximab has shown promising results in the treatment of PG, with complete healing of skin lesions reported in a series of 13 cases. […] Plasma exchange, intravenous immunoglobulin, hyperbaric oxygen therapy, thalidomide, nicotine, and potassium iodide have also been used with varying success in the management of PG. […] PG, although clinically characteristic, remains an enigma with regard to its etiology and pathogenesis.

• #19 Septic Shock after Treatment of Pyoderma Gangrenosum with Infliximab | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-0540

  Since severe infections are often recognized only at an advanced stage and can be poorly controlled by high-dose intravenous antibiotics, there is a strong need for early and effective therapy. Some authors have suggested the use of prophylactic treatment with antibiotics, e.g. in patients with fistulating Crohns disease (14). […] To be able to control these risks, it is necessary to establish an individualized prophylaxis before starting anti-TNF- treatment. Antibiotics that are specifically adapted to the individual wound flora may be considered necessary as prophylaxis.

• #20 Septic Shock after Treatment of Pyoderma Gangrenosum with Infliximab | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-0540

  Since severe infections are often recognized only at an advanced stage and can be poorly controlled by high-dose intravenous antibiotics, there is a strong need for early and effective therapy. Some authors have suggested the use of prophylactic treatment with antibiotics, e.g. in patients with fistulating Crohns disease (14). […] To be able to control these risks, it is necessary to establish an individualized prophylaxis before starting anti-TNF- treatment. Antibiotics that are specifically adapted to the individual wound flora may be considered necessary as prophylaxis.

• #21 Septic Shock after Treatment of Pyoderma Gangrenosum with Infliximab | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-0540

  Since severe infections are often recognized only at an advanced stage and can be poorly controlled by high-dose intravenous antibiotics, there is a strong need for early and effective therapy. Some authors have suggested the use of prophylactic treatment with antibiotics, e.g. in patients with fistulating Crohns disease (14). […] To be able to control these risks, it is necessary to establish an individualized prophylaxis before starting anti-TNF- treatment. Antibiotics that are specifically adapted to the individual wound flora may be considered necessary as prophylaxis.

• #22 Treatment of Peristomal Pyoderma Gangrenosum With Topical Crushed Dapsone – JDDonline – Journal of Drugs in Dermatology

  https://jddonline.com/articles/treatment-of-peristomal-pyoderma-gangrenosum-with-topical-crushed-dapsone-S1545961611P1059X

  Controlling the underlying disease is the initial step in treatment. […] Wound care is important to prevent bacterial infection at the site. Maintenance of clean, dry, dressings decreases risk of infection at ulcer sites.

• #23 Treatment-resistant pyoderma gangrenosum managed with maggot debridement therapy and hyperbaric oxygen therapy: a case study – Wounds UK

  https://wounds-uk.com/journal-articles/treatment-resistant-pyoderma-gangrenosum-managed-with-maggot-debridement-therapy-and-hyperbaric-oxygen-therapy-a-case-study/

  Ongoing immunosuppression is essential to ensure the switching off of the immune process and treat the pyoderma gangrenosum. […] The treatment of pyoderma gangrenosum can be challenging. There are no standardised guidelines, furthermore, management is largely based on case reports and case series. The main goal is immunosuppression leading to wound healing, noting that comorbidities such as diabetes or peripheral vascular disease may prolong and adversely affect healing. […] Wound care is an important aspect of pyoderma gangrenosum management and debridement of non-viable tissue may be required. Debridement strategies in chronic wound care are well established and are most commonly surgical, autolytic, osmotic or maggot debridement therapy types. […] HBOT is a process of supplying tissue with oxygen to promote healing. Wounds, such as in pyoderma gangrenosum, are starved of oxygen and therefore healing is diminished.

• #24 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  It is essential to exclude other diagnoses such as infectious diseases before therapy is initiated as corticosteroid and immunosuppressant therapy is the mainstay in the treatment of PG. […] The treatment of the underlying disease may aid in healing the ulcer. […] In patients without an identifiable associated disease, it is still possible for it to appear later; hence evaluation is indicated even after the skin lesions have healed. […] Local therapy is an important adjunct to systemic therapy and may provide relief from symptoms. […] Gentle debridement of the ulcer can be done with Burrows solution, silver nitrate or potassium permanganate baths. […] Aggressive surgical debridement or skin grafting is discouraged because of the risk of a pathergic response. […] However, skin grafting may be successful if systemic steroid cover is given during the procedure and until both the graft and donor sites have healed.

• #25 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  It is essential to exclude other diagnoses such as infectious diseases before therapy is initiated as corticosteroid and immunosuppressant therapy is the mainstay in the treatment of PG. […] The treatment of the underlying disease may aid in healing the ulcer. […] In patients without an identifiable associated disease, it is still possible for it to appear later; hence evaluation is indicated even after the skin lesions have healed. […] Local therapy is an important adjunct to systemic therapy and may provide relief from symptoms. […] Gentle debridement of the ulcer can be done with Burrows solution, silver nitrate or potassium permanganate baths. […] Aggressive surgical debridement or skin grafting is discouraged because of the risk of a pathergic response. […] However, skin grafting may be successful if systemic steroid cover is given during the procedure and until both the graft and donor sites have healed.

• #26 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  It is essential to exclude other diagnoses such as infectious diseases before therapy is initiated as corticosteroid and immunosuppressant therapy is the mainstay in the treatment of PG. […] The treatment of the underlying disease may aid in healing the ulcer. […] In patients without an identifiable associated disease, it is still possible for it to appear later; hence evaluation is indicated even after the skin lesions have healed. […] Local therapy is an important adjunct to systemic therapy and may provide relief from symptoms. […] Gentle debridement of the ulcer can be done with Burrows solution, silver nitrate or potassium permanganate baths. […] Aggressive surgical debridement or skin grafting is discouraged because of the risk of a pathergic response. […] However, skin grafting may be successful if systemic steroid cover is given during the procedure and until both the graft and donor sites have healed.

• #27 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  Recently, infliximab has shown promising results in the treatment of PG, with complete healing of skin lesions reported in a series of 13 cases. […] Plasma exchange, intravenous immunoglobulin, hyperbaric oxygen therapy, thalidomide, nicotine, and potassium iodide have also been used with varying success in the management of PG. […] PG, although clinically characteristic, remains an enigma with regard to its etiology and pathogenesis.

• #28 Treatment-resistant pyoderma gangrenosum managed with maggot debridement therapy and hyperbaric oxygen therapy: a case study – Wounds UK

  https://wounds-uk.com/journal-articles/treatment-resistant-pyoderma-gangrenosum-managed-with-maggot-debridement-therapy-and-hyperbaric-oxygen-therapy-a-case-study/

  Ongoing immunosuppression is essential to ensure the switching off of the immune process and treat the pyoderma gangrenosum. […] The treatment of pyoderma gangrenosum can be challenging. There are no standardised guidelines, furthermore, management is largely based on case reports and case series. The main goal is immunosuppression leading to wound healing, noting that comorbidities such as diabetes or peripheral vascular disease may prolong and adversely affect healing. […] Wound care is an important aspect of pyoderma gangrenosum management and debridement of non-viable tissue may be required. Debridement strategies in chronic wound care are well established and are most commonly surgical, autolytic, osmotic or maggot debridement therapy types. […] HBOT is a process of supplying tissue with oxygen to promote healing. Wounds, such as in pyoderma gangrenosum, are starved of oxygen and therefore healing is diminished.

• #29 Treatment-resistant pyoderma gangrenosum managed with maggot debridement therapy and hyperbaric oxygen therapy: a case study – Wounds UK

  https://wounds-uk.com/journal-articles/treatment-resistant-pyoderma-gangrenosum-managed-with-maggot-debridement-therapy-and-hyperbaric-oxygen-therapy-a-case-study/

  The positive effects of HBOT in refractory pyoderma gangrenosum have been described. […] Our case highlights how significant improvements in wound healing and pain reduction can be achieved by considering non-traditional treatment approaches in patients with refractory pyoderma gangrenosum. Immunosuppressive therapy is ongoing to ensure ulcer healing and clearance. Nonetheless, this report shows that maggot debridement therapy and HBOT may be considered in similar cases in the future.

• #30 Treatment-resistant pyoderma gangrenosum managed with maggot debridement therapy and hyperbaric oxygen therapy: a case study – Wounds UK

  https://wounds-uk.com/journal-articles/treatment-resistant-pyoderma-gangrenosum-managed-with-maggot-debridement-therapy-and-hyperbaric-oxygen-therapy-a-case-study/

  The positive effects of HBOT in refractory pyoderma gangrenosum have been described. […] Our case highlights how significant improvements in wound healing and pain reduction can be achieved by considering non-traditional treatment approaches in patients with refractory pyoderma gangrenosum. Immunosuppressive therapy is ongoing to ensure ulcer healing and clearance. Nonetheless, this report shows that maggot debridement therapy and HBOT may be considered in similar cases in the future.

• #31 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  Recently, infliximab has shown promising results in the treatment of PG, with complete healing of skin lesions reported in a series of 13 cases. […] Plasma exchange, intravenous immunoglobulin, hyperbaric oxygen therapy, thalidomide, nicotine, and potassium iodide have also been used with varying success in the management of PG. […] PG, although clinically characteristic, remains an enigma with regard to its etiology and pathogenesis.

• #32 Causes, Symptoms & Treatment of Pyoderma Gangrenosum

  https://legsmatter.org/information-and-support/skin-concerns/pyoderma-gangrenosum/

  The Dermatologist will be able to advise on the risk of recurrence and this will be related to the cause, whether it was spontaneous and how well the ulceration responded to the medication. […] It is recommended to keep wearing compression socks to support the leg and reduce the risk of recurrence, especially if there was significant lower leg swelling.

• #33 Management of pyoderma gangrenosum – An update – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/management-of-pyoderma-gangrenosum-an-update/

  It is essential to exclude other diagnoses such as infectious diseases before therapy is initiated as corticosteroid and immunosuppressant therapy is the mainstay in the treatment of PG. […] The treatment of the underlying disease may aid in healing the ulcer. […] In patients without an identifiable associated disease, it is still possible for it to appear later; hence evaluation is indicated even after the skin lesions have healed. […] Local therapy is an important adjunct to systemic therapy and may provide relief from symptoms. […] Gentle debridement of the ulcer can be done with Burrows solution, silver nitrate or potassium permanganate baths. […] Aggressive surgical debridement or skin grafting is discouraged because of the risk of a pathergic response. […] However, skin grafting may be successful if systemic steroid cover is given during the procedure and until both the graft and donor sites have healed.

• #34 Topical treatment of pyoderma gangrenosum: A systematic review – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/topical-treatment-of-pyoderma-gangrenosum-a-systematic-review/

  Systemic immunosuppressants are the mainstay of treatment for pyoderma gangrenosum (PG), but they generally have significant side effects which may be avoided by limiting treatment to topical therapy. […] The greatest weight of the current evidence for topical therapy favours either corticosteroids or calcineurin inhibitors. According to our review, both these options appear well tolerated with a few side effects and may have similar efficacy in speeding up the resolution of PG ulcers. Topical therapy could be considered for use in combination with systemic treatment. There may also be a role for isolated topical monotherapy in selected patients with PG, especially those with early or mild disease and those with idiopathic PG. However further research is needed to confirm this and establish optimal treatment approaches for this condition.

• #35 Topical treatment of pyoderma gangrenosum: A systematic review – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/topical-treatment-of-pyoderma-gangrenosum-a-systematic-review/

  The most widely used topical treatments for PG are corticosteroids and calcineurin inhibitors. The available evidence suggests that they are likely to have similar efficacy and are generally well tolerated. […] In patients with idiopathic PG and small, early-onset lesions, there may be a greater role for topical monotherapy. For these patients, early intervention with topical treatment may present a preferable treatment option to prolonged therapy with systemic immunosuppression.

• #36 Topical Therapy for Pyoderma Gangrenosum Safe, Effective | Skin and Cancer Associates – Hallandale Beach

  https://dermatologyhallandale.com/2019/01/24/topical-therapy-for-pyoderma-gangrenosum-safe-effective/

  The use of high-potency topical corticosteroid therapy in patients with pyoderma gangrenosum (PG) is an effective first-line treatment that avoids the possible adverse effects associated with the use of systemic therapies, according to the results of a recent study. […] Overall, 43.8% of the participants healed with the use of topical therapy alone within the 6-month treatment period. […] The investigators concluded that clobetasol propionate 0.05% demonstrated potential use as a first-line treatment for patients with PG, particularly those with small lesions. […] Whether more severe PG will respond adequately to topical treatment alone requires further elucidation, with larger ulcerations possibly requiring more intensive therapy.

• #37 Treatment-resistant pyoderma gangrenosum managed with maggot debridement therapy and hyperbaric oxygen therapy: a case study – Wounds UK

  https://wounds-uk.com/journal-articles/treatment-resistant-pyoderma-gangrenosum-managed-with-maggot-debridement-therapy-and-hyperbaric-oxygen-therapy-a-case-study/

  Ongoing immunosuppression is essential to ensure the switching off of the immune process and treat the pyoderma gangrenosum. […] The treatment of pyoderma gangrenosum can be challenging. There are no standardised guidelines, furthermore, management is largely based on case reports and case series. The main goal is immunosuppression leading to wound healing, noting that comorbidities such as diabetes or peripheral vascular disease may prolong and adversely affect healing. […] Wound care is an important aspect of pyoderma gangrenosum management and debridement of non-viable tissue may be required. Debridement strategies in chronic wound care are well established and are most commonly surgical, autolytic, osmotic or maggot debridement therapy types. […] HBOT is a process of supplying tissue with oxygen to promote healing. Wounds, such as in pyoderma gangrenosum, are starved of oxygen and therefore healing is diminished.

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