Split Skin Grafts in the Treatment of Pyoderma Gangrenosum

Cliff, S.; Holden, C.A.; Thomas, P.; Marsden, R.A.; Harland, C.C.

doi:10.1046/j.1524-4725.1999.08193.x

Cited by 44 publications

(34 citation statements)

References 19 publications

(27 reference statements)

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“…Die Literatur zeigt jedoch vielversprechende Ergebnisse und gute Langzeitverläufe nach Spalthauttransplantation [9,14] oder auch nach EpiDex-Transplantation [13]. Laut Cliff et al [5] wird das kosmetische Ergebnis nach Spalthauttransplantation besser als bei Sekundärheilung. Die zentrale Prä-misse für die operative Sanierung ist die längerfristige Immunsuppression.…”

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Chirurgische Therapie beim Pyoderma gangraenosum

2011

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Pyoderma gangrenosum is a rare affection of unknown etiology, which is often associated with systemic diseases such as chronic inflammatory bowel disease, hematologic disorders, carcinomas and arthritis. Treatment may include topical corticosteroids or calcineurin inhibitors in combination with systemic corticosteroids, cyclosporine A, azathioprine, cyclophosphamide, mycophenolate mofetil, intravenous immunoglobulins or monoclonal antibodies against TNFα but all these approaches are off-label. Surgical therapy is difficult because of pathergy. Nevertheless, after having stopped the inflammation, the ulcers can be treated by split thickness skin grafts and simultaneous immunosuppression. We present three cases with successful surgical treatment.

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“…Die aktuelle Literatur zeigt wiederholt Fälle, in denen chirurgische Therapie die Abheilung des Pyoderma gangraenosum deutlich beschleunigen konnte [5,16,18].…”

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Chirurgische Therapie beim Pyoderma gangraenosum

2011

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“…Split-skin grafts may sometimes be indicated [90]. In exceptional cases, surgery may be the only remedy left [91].…”

Section: Split-skin Grafts Local Excision Limb Resectionmentioning

confidence: 99%

Extraintestinal complications of inflammatory bowel disease

Bodegraven

Dijkmans

Lips

et al. 2001

Curr Treat Options Gastro

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Extraintestinal complications of inflammatory bowel disease (IBD) are often secondary to the underlying disease. Therefore, the first priority is to get active IBD into remission with medications, since surgery for IBD is not indicated for the treatment of extraintestinal complications. Symptoms of extraintestinal complications usually can be treated with simple agents; the treatment of patients with refractory symptoms and the use of more complex drug regimens should be done in cooperation with specialists on affected organ systems. Careful consideration of prescribed drugs is necessary because they may negatively influence the course of IBD.

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“…3,4 Selected cases of PG treated with two different surgical techniques have been reported so far: the simultaneous application of free anterolateral thigh fasciocutaneous flaps after radical debridement 5 and split-thickness skin graft. 6 We herein report the case of a patient with PG and ulcerative colitis treated with the simultaneous and combined approach of therapy with infliximab and surgery.…”

Section: Introductionmentioning

confidence: 99%

A case of pyoderma gangrenosum with ulcerative colitis treated with combined approach: Infliximab and surgery

Andrisani¹,

Guidi²,

Papa³

et al. 2013

Journal of Crohn's and Colitis

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Pyoderma gangrenosum (PG) is an ulcerating noninfectious disease of the skin seen in 1-2% of patients with inflammatory bowel disease (IBD). The pathogenesis of PG has yet to be determined, but may be related to abnormal T cell responses and the production of TNF-α, a pathway also involved in IBD pathogenesis. Infliximab, a chimeric monoclonal antibody to TNF-α, is used to treat moderate to severe IBD and several case reports and studies suggest the efficacy of infliximab in the treatment of PG. The surgical approach to PG is reserved to a few selected cases. We report here the case of a patient with ulcerative colitis (UC) and PG localized on the left breast, treated with a simultaneous combined medical and surgical approach.

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Split Skin Grafts in the Treatment of Pyoderma Gangrenosum

Cited by 44 publications

References 19 publications

Chirurgische Therapie beim Pyoderma gangraenosum

Chirurgische Therapie beim Pyoderma gangraenosum

Extraintestinal complications of inflammatory bowel disease

A case of pyoderma gangrenosum with ulcerative colitis treated with combined approach: Infliximab and surgery

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