Pyoderma gangrenosum. Response to cyclophosphamide therapy

Abstract

A 46-year-old woman had a 17-year history of intermittently severe pyoderma gangrenosum without identifiable associated systemic disease. Her condition had become unresponsive to corticosteroid and sulfone therapy given for systemic effect, but responded completely to 150 mg/day of cyclophosphamide. Immunosuppressive therapy should be considered in patients with severe, recalcitrant pyoderma gangrenosum, even in the absence of associated systemic disease.

Leg ulcers in the antiphospholipid syndrome may be considered as a form of pyoderma gangrenosum and they respond favorably to treatment with immunosuppression and anticoagulation

“…Immunosuppressive agents are also necessaries in patients who fail to respond to systemic corticosteroids, or who develop steroid-related side effects. Others treatments in refractory PG have been used such as oral azathioprine [13], cyclophosphamide [14], cyclosporine [15], tacrolimus [16], intravenous immunoglobulin [17] mycophenolate mophetil [18] or methotrexate [19]. Recently, anti-tumor necrosis factor alpha have been reported as effectives in refractory cases [20].…”

Atypical pyoderma gangrenosum in inflammatory bowel disease: A severe diagnostic challenge

“…In the most severe and corticorefractary cases, cyclosporine A, tacrolimus, azathioprine, or micophenolate mofetil, ciclophosphamide, clorambucil, intravenous gammaglobulin, thalidomide, etanercept, Infliximab, adalimumab, clofazimine, dapsone, metronidazole and nicotine have been used (14)(15)(16)(17)(18). Some studies have shown that treatment of resistant cases can be done with other immunosuppressants.…”

Minocycline Hydrochloride Hyperpigmentation Complicating Treatment of Pyoderma Gangrenosum

“…Minocycline is a semi-synthetic tetracycline with broad spectrum antibiotic activity. Systemic steroid therapy, although effective in PG, carries an appreciable morbidity and even rnor- tality, so several alternative therapies have been used with efficacy (3)(4)(5). There are some previous reports that have suggested that minocycline might be efficacious in PG (1).…”