Pulse therapy. Therapeutic efficacy in the treatment of pyoderma gangrenosum

Johnson, Robert B.; Lazarus, Gerald S.

doi:10.1001/archderm.118.2.76

Cited by 89 publications

(35 citation statements)

References 71 publications

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“…Systemic therapy is based on oral steroids at doses of 0.5–2 mg/kg/day. If not successful, methylprednisolone 1 mg/kg in continuous infusion for 1–5 consecutive days [4, 6, 7] or cyclosporine in a dosage of 4–5 mg/kg/day has been associated with rapid responses [8,9,10,11,12]. Azathioprine [4, 58, 59], methotrexate [60], tacrolimus [61,62,63,64], thalidomide [65], dapsone [66, 67], mycophenolate mofetil [68], cyclophosphamide [69] and colchicine [70] have shown some effectiveness in case reports.…”

Section: Discussionmentioning

confidence: 99%

“…Topical treatment alone is usually insufficient for both idiopathic and IBD-associated PG. Topical anti-inflammatory medication should only be used in combination with systemic treatments such as oral or intravenous corticosteroids [4, 6, 7]. Cyclosporine, mycophenolate mofetil, dapsone and other immunosuppressive agents have been used successfully as steroid-sparing drugs [8,9,10,11,12].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Infliximab for the Treatment of Disseminated Pyoderma Gangrenosum Associated with Ulcerative Colitis

Juillerat¹,

Christen-Zäch

Troillet³

et al. 2007

Dermatology

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We report the case of a 19-year-old woman who developed an acute disseminated pyoderma gangrenosum (PG) during a severe flare of ulcerative colitis (UC). She was successfully treated with a 3-dose regimen of the anti-tumor-necrosis-factor-α antibody infliximab. The literature on the effectiveness of this biological agent was reviewed, including 8 other cases of UC-associated PG and 77 cases of Crohn’s-disease-associated PG. This case report and the review of the literature demonstrate that infliximab can be successfully used to treat patients with PG associated with inflammatory bowel diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Infliximab for the Treatment of Disseminated Pyoderma Gangrenosum Associated with Ulcerative Colitis

Juillerat¹,

Christen-Zäch

Troillet³

et al. 2007

Dermatology

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“…High-dose intravenous steroid pulse therapy is recommended for refractory cases [47]. Prystowsky et al [48] noted good clinical results in 6 of 8 PG patients treated with methylprednisolone over 3–5 days.…”

Section: Treatmentmentioning

confidence: 99%

Extraintestinal Manifestations of Crohn’s Disease

et al. 2005

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In each case of extraintestinal manifestations of Crohn’s disease, active disease, if present, should be treated to induce remission, which may positively influence the course of most concomitant extraintestinal manifestations. For some extraintestinal manifestations, however, a specific treatment should be introduced. This latter part of disease management will be discussed in this chapter, in particular for pyoderma gangrenosum, uveitis, spondylarthropathy – axial arthropathy – and primarysclerosing cholangitis, which have also been described in quiescent Crohn’s disease. Few new drugs for the treatment of extraintestinal manifestations of Crohn’s disease have been developed in the past and only the role of infliximab has increased in Crohn’s disease-related extraintestinal manifestations. Drugs specifically aimed at this treatment, stemming from a few randomized controlled studies or case series, are sulfasalazine, 5-ASA, corticosteroids, azathioprine or 6-mercaptopurine, methotrexate, infliximab, dapsone and cyclosporine or tacrolimus.

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“…1,4 It is important to investigate the history of drug use that could have worsened the pyoderma gangrenosum, such as isotretinoin and acitretin. 5 The differential diagnosis should exclude the following diseases: vasculites, syphilis, neoplasias, phospholipid syndrome and mycobacterial infections.…”

Section: Discussionmentioning

confidence: 99%