TY - JOUR
T1 - Pyoderma gangrenosum
T2 - Study of 21 patients and proposal of a 'clinicotherapeutic' classification
AU - Marzano, Angelo Valerio
AU - Trevisan, Valentina
AU - Lazzari, Riccardo
AU - Crosti, Carlo
PY - 2011/10
Y1 - 2011/10
N2 - Background: Pyoderma gangrenosum (PG) is a rare, relapsing inflammatory disorder classified within the neutrophilic dermatoses. It can be idiopathic or associated with various conditions. The management of PG includes several immunosuppressants, but definite guidelines are still lacking. Objective: To propose a 'clinicotherapeutic' classification for PG; namely, a therapeutic algorithm for this disease on the basis of the clinical extent of lesions. Methods: Twenty-one patients with PG referred to our department during the last 3 years were prospectively studied. They were subdivided into three subsets localized, multilesional and disseminated on the basis of the number of lesions and percentage of involved body surface area. Results: The end point was fulfilled in all the aforementioned settings of PG. Topical tacrolimus proved to be useful in localized PG. Multilesional PG was successfully treated with prednisone alone or in combination with cyclosporine. Disseminated PG responded well to prednisone plus cyclosporine, except for refractory cases in which infliximab was employed. Conclusions: This clinicotherapeutic classification seems to work well in PG, although its impact on the incidence of relapses is poorly evaluable due to the short follow-ups in our study; controlled trials are needed to confirm its value.
AB - Background: Pyoderma gangrenosum (PG) is a rare, relapsing inflammatory disorder classified within the neutrophilic dermatoses. It can be idiopathic or associated with various conditions. The management of PG includes several immunosuppressants, but definite guidelines are still lacking. Objective: To propose a 'clinicotherapeutic' classification for PG; namely, a therapeutic algorithm for this disease on the basis of the clinical extent of lesions. Methods: Twenty-one patients with PG referred to our department during the last 3 years were prospectively studied. They were subdivided into three subsets localized, multilesional and disseminated on the basis of the number of lesions and percentage of involved body surface area. Results: The end point was fulfilled in all the aforementioned settings of PG. Topical tacrolimus proved to be useful in localized PG. Multilesional PG was successfully treated with prednisone alone or in combination with cyclosporine. Disseminated PG responded well to prednisone plus cyclosporine, except for refractory cases in which infliximab was employed. Conclusions: This clinicotherapeutic classification seems to work well in PG, although its impact on the incidence of relapses is poorly evaluable due to the short follow-ups in our study; controlled trials are needed to confirm its value.
KW - Classification
KW - Cyclosporine
KW - Infliximab
KW - Prednisone
KW - Pyoderma gangrenosum
KW - Topical tacrolimus
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U2 - 10.3109/09546631003686069
DO - 10.3109/09546631003686069
M3 - Article
C2 - 20666672
AN - SCOPUS:80053089167
VL - 22
SP - 254
EP - 260
JO - Journal of Dermatological Treatment
JF - Journal of Dermatological Treatment
SN - 0954-6634
IS - 5
ER -