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PubMed2001

Superficial granulomatous pyoderma gangrenosum of the face, successfully treated by ciclosporine: a long-term follow-up.

We report a case of the superficial granulomatous (vegetating) form of pyoderma gangrenosum, involving the forehead and the left temporal area in a 44-year-old woman. No association with other pathologies could be found. Lesions responded dramatically to systemic ciclosporine (5 mg/kg/day), and complete healing was reached after 6 months. Doses were tapered progressively. Treatment was discontinued after 4.5 years. Discontinuation was not followed by recurrence of the disease. Healing is maintained after another 4.5 years of follow-up.

Administration, Oral↗
PubMed2002

Topical treatment of pyoderma gangraenosum.

The treatment of pyoderma gangraenosum (PG) is still a therapeutic challenge. Although several drugs such as corticosteroids, dapsone, clofazimine, azathioprine, tacrolimus and cyclosporine A have been shown to be effective in this disease, side-effects of these agents limit their systemic use in seriously ill patients. In recent years, topical treatment of the disease has gained attention. Several reports show an improvement of cutaneous lesions of PG following topical treatment. These earlier reports as well as our own observations suggest that topical therapeutic regimens can be a useful and safe alternative to systemic immunosuppressive therapy in the treatment of PG. We give a review about these topically used drugs and the mechanisms probably involved.

Administration, Cutaneous↗
PubMed2002

Corticosteroid-resistant pyoderma gangrenosum associated with Crohn's disease: rapid cure with infliximab.

A 41-year-old woman with Crohn's disease had a severe and rapidly extensive corticosteroid-resistant pyoderma gangrenosum (PG) of the leg. She had been treated 2 years previously with antibiotics and surgery for a similar lesion of the back of the hand which had been diagnosed as a fulminating infection. Infliximab 5 mg/kg was given at weeks 0, 5 and 9. A dramatic response was observed within 72 h with a favourable effect persisting for 4 weeks after each infliximab infusion. A complete healing was achieved at week 11. This case illustrates that (1). PG of the hand is frequently misdiagnosed as an infection and treated with inappropriate therapies; (2). infliximab may be an interesting alternative in corticosteroid-resistant PG associated with Crohn's disease.

Adult↗
PubMed1994

Pyoderma-gangraenosum-like ulcers associated with lupus anticoagulant.

A 45-year-old women presented with a deep ulcerative lesion of the left breast. Two months later, a new cutaneous necrotic lesion located in the right pretibial areas was observed. The only serum abnormality was the presence of circulating lupus anticoagulant. Clinical features suggested the diagnosis of pyoderma gangraenosum and histologic examination showed microthrombosis in the dermal capillary vessels adjacent to a dense, mixed inflammatory infiltrate with some degree of vascular damage. Although thrombosis may be the result of vasculitis, it is likely that in our patient the presence of a lupus anticoagulant activity played a role in the pathogenesis of the cutaneous ulcers.

Breast↗
PubMed1993

Superficial granulomatous pyoderma.

We report the case of a 66-year-old man presenting 2 chronic, slowly expanding skin lesions having clinical and histopathological characteristics of superficial granulomatous pyoderma. Sulfone treatment induced healing with scar formation.

Abscess↗
PubMed1993

Cutaneous manifestations in Kartagener's syndrome: folliculitis, nummular eczema and pyoderma gangraenosum.

We report the case of a 47-year-old male with Kartagener's syndrome (KS; situs inversus, bronchitis and sinusitis) who showed three types of cutaneous lesions: recurrent outbreaks of nummular eczema, recurrent deep folliculitis and two episodes of pyoderma gangraenosum. The patient had also IgA gammopathy of undetermined significance. This is the second case of KS associated with cutaneous lesions published so far and suggests that primary ciliary dyskinesia syndromes may have skin symptoms.

Eczema↗
PubMed1988

Clofazimine in dermatitis ulcerosa (pyoderma gangrenosum). Open clinical trial.

Five patients suffering from dermatitis ulcerosa (a variant of pyoderma gangrenosum) were treated with clofazimine in a daily dosage of 200 mg orally. Complete healing was noted in 2 patients, partial response in 2, no effect in 1. Side effects were mild and transitory in form of a red coloring of the skin (all patients) and mild ichthyosis (2 patients).

Adult↗
PubMed1986

Serum C-reactive protein measurement in pyoderma gangrenosum.

A case of pyoderma gangrenosum is reported in a patient with a past history of ulcerative colitis. Serial C-reactive protein (CRP) concentrations were measured and were found to be markedly elevated at presentation. Levels were also raised during two subsequent relapses. CRP levels proved to be a useful objective indicator of disease activity and response to therapy, and reflected changes in disease activity before the erythrocyte sedimentation rate.

C-Reactive Protein↗
PubMed1984

Pyoderma gangrenosum associated with selective hereditary IgA deficiency.

A case of pyoderma gangrenosum is described in a girl aged 4. The condition was associated with selective IgA deficiency. The father and the 2 brothers suffered from the same deficiency (autosomal dominant transmission). Treatment with prednisolone and clofazimine produced an excellent clinical response.

Child, Preschool↗
PubMed1980

Recurrent chronic pyoderma with cellular immunodeficiency. Successful therapy by levamisole.

In a 21-year-old male patient afflicted with widespread recurrent pyoderma resistent to antimicrobial therapy since 3 years, a deficient state of cellular immunity including dysfunctions of both microphages and T lymphocytes was disclosed. After 6 weeks of systemic treatment with levamisole all lesions cleared completely, whereas appropriate long-term antibiotic therapy previously administered had failed to succeed. The immunological parameters, as far as being reexamined, also returned to normal levels during levamisole therapy.

Adult↗
PubMed1979

Chronic pyoderma in splenectomized patient.

This is a report of a case with a chronic peculiar intractable pyoderma. The process started a year after splenectomy because of trauma. In the absence of an apparent other reason, we assume that a relationship exists between the operation and the skin disease.

Adolescent↗
PubMed1976

Pyoderma gangrenosum in immunosuppressed patients.

Two cases with pyoderma gangrenosum are presented. The course, in both cases, suggested that immunosuppressive therapy may play an etiological role in the disease. The first was a kidney recipient receiving prednisone and azathioprine and the second, a patient with pemphigus vulgaris who was treated with prednisone and methotrexate.

Adult↗
PubMed1982

A transient deficit in neutrophilic chemotaxis in a dog with recurrent staphylococcal pyoderma.

A transient neutrophilic chemotactic deficit was confirmed in a 3 1/2-year-old castrated male dog with recurrent staphylococcal pyoderma accompanied by a persistent eosinophilia and intermittent basophilia. Neutrophilic chemotaxis was quantitatively assessed over the next seven months, and the disappearance of the chemotactic deficit correlated with complete clinical remission of the skin lesions. Aberrations of the complement system were not discovered, and the dog's serum showed increased chemoattractiveness for control neutrophil preparations.

Animals↗
PubMed2003

Treatment of an atypical leg ulcer: pyoderma gangrenosum.

Mrs B was referred to the Skin and Woundcare Department at the start of January 2002 with a chronic non-healing ulcer to her lower right leg proximal to the medial aspect of her right knee. The ulcer was diagnosed as pyoderma gangrenosum, a condition which Mrs B had suffered from previously. Assessment and management of this atypical ulcer are discussed. Once the progression of the lesion was halted, conservative treatment could be undertaken, and led to a successful outcome.

Chronic Disease↗
PubMed2000

The diagnosis and treatment of pyoderma gangraenosum.

Pyoderma gangraenosum is a rare condition and its symptoms are often misdiagnosed. This article presents of an overview of this form of ulceration, and includes a case study showing how it was diagnosed and treated in a patient following an arthroscopy to the left ankle.

Aged↗
PubMed1997

Rapidly progressive renal failure occurring in the course of pyoderma gangrenosum and IgA (lambda) monoclonal gammopathy.

A 50-year-old man with a 7-year history of an ulcerative rash on the lower extremities had rapidly progressive renal failure. Monoclonal IgA (lambda) was detected in his serum. Kidney biopsy revealed proliferative glomerulonephritis with dominant IgA and C3 deposition, compatible with IgA nephropathy. Immunohistochemical staining with anti-lambda chain was negative and electron microscopic examination revealed deposits in subendothelial and mesangial areas. The findings on the skin biopsy were consistent with that of a pyoderma gangrenosum. The patient was treated with prednisolone pulse therapy followed by oral prednisolone. Renal function gradually and almost completely improved and proteinuria disappeared.

Acute Kidney Injury↗
PubMed1998

Pyoderma gangrenosum following cytosine arabinoside, aclarubicin and granulocyte colony-stimulating factor combination therapy in myelodysplastic syndrome.

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis, which may be associated with systemic conditions such as hematologic disorders. We present a patient who had been diagnosed as having myelodysplastic syndrome associated with PG at onset, in whom a febrile ulcerative skin lesion developed following cytosine arabinoside, aclarubicin and granulocyte colony-stimulating factor (G-CSF) combination chemotherapy in the course of the disease. Skin biopsy revealed dense neutrophilic infiltrate in the dermis with central epidermal ulceration, consistent with the diagnosis of PG. Oral prednisolone was effective for the skin lesion. In this case, G-CSF application may participate in the recurrence of PG.

Aclarubicin↗