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Pyoderma gangrenosum treated with high-dose intravenous immunoglobulins: Two cases and review of the literature.

Abstract
Pyoderma gangrenosum (PG) is a neutrophilic skin disease commonly treated with immunosuppressants. High-dose intravenous immunoglobulins are used to treat a range of inflammatory diseases, but we found only five reports of the use of high-dose intravenous immunoglobulins in the treatment of PG. We report on two patients with PG for whom immunosuppressants could not be prescribed and who were treated with high-dose intravenous immunoglobulins. Case 1 was a 58-year-old man who presented with a 6-year history of PG. He was initially treated with prednisone. The 20 mg/day dosage of prednisone could not be reduced and treatment had to be discontinued after 1 year because of serious adverse effects. Minocycline treatment led to improvement but had to be discontinued after 6 years because of facial skin hyperpigmentation. Case 2 was a 66-year-old man who presented with a 3-year history of PG. Different therapeutic procedures for PG (prednisone, topical tacrolimus or betamethasone) had failed. High-dose intravenous immunoglobulins were administered monthly at a dose of 2 g/kg for 6 months. The treatment induced stabilisation of the disease and made it possible to reduce corticosteroid use in both patients. These cases show that high-dose intravenous immunoglobulins represent a therapeutic alternative for PG, but the efficacy of this treatment should be confirmed in further studies.
AuthorsNicolas Meyer, Valérie Ferraro, Marie-Henriette Mignard, Henri Adamski, Jacqueline Chevrant-Breton
JournalClinical drug investigation (Clin Drug Investig) Vol. 26 Issue 9 Pg. 541-6 ( 2006) ISSN: 1173-2563 [Print] New Zealand
PMID17163287 (Publication Type: Case Reports, Journal Article, Review)
Chemical References
  • Immunoglobulins, Intravenous
Topics
  • Aged
  • Humans
  • Immunoglobulins, Intravenous (therapeutic use)
  • Male
  • Middle Aged
  • Pyoderma Gangrenosum (drug therapy)

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