Pyoderma gangrenosum of the breast treated with intravenous immunoglobulin

Sinnya, Sudipta; Hamza, Saud

doi:10.3315/jdcr.2013.1140

Cited by 19 publications

(15 citation statements)

References 27 publications

(44 reference statements)

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“…Our literature search yielded 26 articles, which describe 43 cases of PG treated with IVIG (see Fig. and Table S1; see Supporting Information) . The retrospective review identified six patients with PG treated with IVIG at our institutions.…”

Section: Resultsmentioning

confidence: 99%

Intravenous immunoglobulin as adjunct therapy for refractory pyoderma gangrenosum: systematic review of cases and case series

2018

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Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis. Treatment regimens for refractory cases are nonstandardized. Intravenous immunoglobulin (IVIG) is an emerging treatment with reported success, but the efficacy of IVIG for PG is unknown. In this systematic review of cases and case series, we assessed the efficacy of IVIG for the treatment of PG, as observed at our institution and reported in the literature. A retrospective chart review at two tertiary care hospitals between 2000 and 2015, and literature searches in PubMed/MEDLINE, EMBASE and Web of Science from all years were conducted. In total, there were 49 patients, including 43 patients from 26 articles and six institutional cases. There was complete or partial response in 43 (88%) patients and complete response in 26 (53%) patients. The mean time to initial response to treatment and treatment length were 3·5 (SD 3·3) weeks and 5·9 (SD 7·8) months, respectively. On average, 2·6 treatments had been trialled before IVIG initiation. IVIG was administered with systemic steroids in 43 (88%) cases. Mild adverse events, especially nausea and headache, were reported in 12 (24·5%) patients. Our systematic review suggests a potential role for IVIG as adjuvant therapy for refractory PG. Prospective clinical trials testing the efficacy of IVIG for refractory PG are needed to validate these findings.

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Section: Resultsmentioning

confidence: 99%

Intravenous immunoglobulin as adjunct therapy for refractory pyoderma gangrenosum: systematic review of cases and case series

2018

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“…“Modern” immune modulators ▹Tacrolimus ▹TNF‐α inhibitors –Adalimumab –Etanercept –Infliximab –Ustekinumab ▹IL‐1fl receptor antagonists –Anakinra –Canakinumab ▹Rituximab ▹Intravenous immunoglobulins …”

Section: Discussionmentioning

confidence: 99%

Therapy of pyoderma gangrenosum in Germany: results of a survey among wound experts

Ghazal

Dissemond

2015

J Deutsche Derma Gesell

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“…31,41,42 Other oral and intravenous immunosuppressors have been reported to successfully treat PG, or to be good corticosteroid sparing agents, namely azathioprine, sulfasalazine, dapsone, thalidomide, minocycline, clofazimine, methotrexate, mycophenolate mofetil, tacrolimus, intravenous immunoglobulin, and cyclophosphamide. 53,54 Systemic antibiotics including tetracyclines, vancomycin, rifampicin, and mezlocillin, besides their role in inhibiting secondary bacterial infection, may also modulate the course of PG through anti-inflammatory mechanisms. 6 Over the past decade, PG has been reported to respond to many different biologic medications, most commonly, to anti-TNF drugs such as etanercept, adalimumab, certolizumab, and infliximab.…”

Section: Systemic Treatmentmentioning

confidence: 99%

Pyoderma gangrenosum: challenges and solutions

Gameiro¹,

Pereira²,

Cardoso³

et al. 2015

OTT

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Pyoderma gangrenosum (PG) is a rare disease, but commonly related to important morbidity. PG was first assumed to be infectious, but is now considered an inflammatory neutrophilic disease, often associated with autoimmunity, and with chronic inflammatory and neoplastic diseases. Currently, many aspects of the underlying pathophysiology are not well understood, and etiology still remains unknown. PG presents as painful, single or multiple lesions, with several clinical variants, in different locations, with a non specific histology, which makes the diagnosis challenging and often delayed. In the classic ulcerative variant, characterized by ulcers with inflammatory undermined borders, a broad differential diagnosis of malignancy, infection, and vasculitis needs to be considered, making PG a diagnosis of exclusion. Moreover, there are no definitively accepted diagnostic criteria. Treatment is also challenging since, due to its rarity, clinical trials are difficult to perform, and consequently, there is no "gold standard" therapy. Patients frequently require aggressive immunosuppression, often in multidrug regimens that are not standardized. We reviewed the clinical challenges of PG in order to find helpful clues to improve diagnostic accuracy and the treatment options, namely topical care, systemic drugs, and the new emerging therapies that may reduce morbidity.

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Pyoderma gangrenosum of the breast treated with intravenous immunoglobulin

Cited by 19 publications

References 27 publications

Intravenous immunoglobulin as adjunct therapy for refractory pyoderma gangrenosum: systematic review of cases and case series

Intravenous immunoglobulin as adjunct therapy for refractory pyoderma gangrenosum: systematic review of cases and case series

Therapy of pyoderma gangrenosum in Germany: results of a survey among wound experts

Pyoderma gangrenosum: challenges and solutions

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