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Well-designed studies that help guide physicians to apply the optimal therapeutic strategy for the management of pyoderma gangrenosum are lacking in the literature. A multidisciplinary approach is paramount for the effective management of this condition, with close involvement of a wound-care specialist and a microbiologist. Treatment should be stepwise in nature. Local wound care, avoidance of trauma and the application of local steroid or tacrolimus ointment are the first-line treatments. Steroid therapy is the most widely published effective therapy for achieving resolution of pyoderma gangrenosum, although there is growing evidence for the efficacy of infliximab in refractory cases. Other therapies such as dapsone and clofazamine should be left as third-line agents for refractory pyoderma gangrenosum, while novel treatments such as granulocyte apheresis should only be used under trial conditions, to gain an objective evaluation of their efficacy. This article reviews the published treatment strategies in current use, and aims to guide the effective management of pyoderma gangrenosum.

Original publication

DOI

10.1038/ncpgasthep0339

Type

Journal article

Journal

Nat Clin Pract Gastroenterol Hepatol

Publication Date

12/2005

Volume

2

Pages

587 - 594

Keywords

Anti-Inflammatory Agents, Non-Steroidal, Antibodies, Monoclonal, Blood Component Removal, Dermatologic Agents, Glucocorticoids, Humans, Infliximab, Practice Guidelines as Topic, Pyoderma Gangrenosum, Treatment Outcome, Tumor Necrosis Factor-alpha