Pyoderma Gangrenosum

An idiopathic, rapidly evolving, and severely debilitating disease occurring most commonly in association with chronic ulcerative colitis. It is characterized by the presence of boggy, purplish ulcers with undermined borders, appearing mostly on the legs. The majority of cases are in people between 40 and 60 years old. Its etiology is unknown.

Networked: 838 relevant articles (79 outcomes, 15 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Psoriasis (Pustulosis Palmaris et Plantaris)
2.	Lichen Planus (Lichen Ruber Planus)
3.	Ulcerative Colitis
4.	Skin Diseases
5.	Crohn Disease (Crohn's Disease)

Experts

1.	Rogler, Gerhard: 4 articles (08/2015 - 01/2011)
2.	Vavricka, Stephan R: 4 articles (08/2015 - 01/2011)
3.	Michetti, Pierre: 4 articles (08/2015 - 01/2007)
4.	Morita, Akimichi: 4 articles (03/2015 - 03/2005)
5.	Callen, Jeffrey P: 4 articles (07/2014 - 12/2004)
6.	Homey, B: 4 articles (11/2011 - 02/2000)
7.	Froehlich, Florian: 3 articles (08/2015 - 01/2007)
8.	Lakatos, Peter L: 3 articles (08/2015 - 01/2012)
9.	Peyrin-Biroulet, Laurent: 3 articles (08/2015 - 01/2011)
10.	Katayama, Ichiro: 3 articles (08/2015 - 12/2007)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Pyoderma Gangrenosum:

1.	infliximab (Remicade)FDA Link 12/01/2005 - "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. " 12/01/2003 - "In addition, small studies have shown infliximab to be effective in treating troublesome EIMs, particularly in pyoderma gangrenosum. " 08/01/2003 - "Infliximab is a safe and effective treatment for IBD-associated pyoderma gangrenosum." 05/01/2005 - "A dramatic improvement in his pyoderma gangrenosum was observed after one infusion of infliximab, and a second infusion led to its resolution. " 08/01/2002 - "Infliximab induces remission of pyoderma gangrenosum."
2.	Cyclosporine (Ciclosporin)FDA LinkGeneric 03/01/2008 - "In this paper, we report a series of four patients with pyoderma gangrenosum treated successfully with topical cyclosporine. " 01/01/2009 - "Cyclosporine is effective in the acute management of pyoderma gangrenosum; however, when tapering the drug, additional systemic agents are necessary for maintaining the clinical response. " 09/01/2002 - "Cyclosporine was effective for the skin lesions of pyoderma gangrenosum. " 01/01/1991 - "These results indicate that cyclosporine is useful in the treatment of patients with refractory pyoderma gangrenosum and suggest an immune mechanism in the pathogenesis of this disorder." 11/01/2008 - "Pyoderma gangrenosum can be stabilized with oral cyclosporine administration. "
3.	Tacrolimus (Prograf)FDA LinkGeneric 09/01/2009 - "Monster parastomal pyoderma gangrenosum effectively treated by topical tacrolimus." 03/01/2001 - "Topical tacrolimus has been shown to be effective in the management of pyoderma gangrenosum. " 02/01/2000 - "Topical tacrolimus (FK 506) is effective in the treatment of pyoderma gangrenosum." 10/01/1998 - "Efficacy of tacrolimus (FK 506) in idiopathic treatment-resistant pyoderma gangrenosum." 12/01/1991 - "Efficacy of FK 506 in the treatment of recalcitrant pyoderma gangrenosum."
4.	Prednisolone (Predate)FDA LinkGeneric 03/01/2015 - "Skin biopsy revealed a diagnosis of penile pyoderma gangrenosum, which was treated successfully with prednisolone and an immunosuppressive drug. " 04/01/2014 - "Prednisolone was initiated with significant improvement in the patient's abdominal symptoms and pyoderma gangrenosum. " 12/01/1999 - "An 18-year-old woman and a 65-year-old man had typical lesions of pyoderma gangrenosum on the legs that responded well to oral prednisolone. " 07/09/1999 - "High doses of orally administered prednisolone induced the healing of the pyoderma gangrenosum within 2 months. " 06/18/1990 - "His symptoms responded rapidly to prednisolone therapy, and a diagnosis of pyoderma gangrenosum was confirmed by biopsy. "
5.	DapsoneFDA Link 10/01/2004 - "Behçet's syndrome with pyoderma-gangrenosum-like lesions treated successfully with dapsone monotherapy." 09/01/2011 - "This appears to be the first case of pyoderma gangrenosum treated with crushed dapsone." 09/01/2011 - "Treatment with topical application of crushed dapsone resulted in improvement of his pyoderma gangrenosum. " 09/01/2011 - "Treatment of peristomal pyoderma gangrenosum with topical crushed dapsone." 02/01/2007 - "Sclerokeratitis and facial skin lesions: a case report of pyoderma gangrenosum and its response to dapsone therapy."
6.	Adrenal Cortex Hormones (Corticosteroids)IBA 12/01/2009 - "Pyoderma gangrenosum is effectively treated with systemic corticosteroids." 11/01/2006 - "Therapeutic management was difficult: Pyoderma gangrenosum responded well to corticosteroids but subcorneal pustulosis management was harder and treatments were poorly effective.Pyoderma" 03/01/2007 - "A 26 year-old woman was followed since 2002 for pyoderma gangrenosum occurring during pregnancy and regressing under general corticosteroids. " 11/01/2006 - "If the Pyoderma gangrenosum usually responds to corticosteroids, the subcorneal pustulosis treatments are not well defined and often not efficient. " 01/01/2006 - "Pyoderma gangrenosum was diagnosed and after high dose corticosteroids wound healing started. "
7.	Tumor Necrosis Factor-alpha (Tumor Necrosis Factor)IBA 10/01/2013 - "Pyoderma gangrenosum and tumor necrosis factor α agents." 06/01/2012 - "Good resolution of pyoderma gangrenosum was achieved in 3 patients with tumor necrosis factor α (TNFα) blockade treatment. " 01/01/2008 - "Recently tumor necrosis factor alpha inhibitors have been gaining attention in the treatment of recalcitrant pyoderma gangrenosum. " 12/01/2007 - "Expression of MMP-9, MMP-10 and TNF-alpha and lack of epithelial MMP-1 and MMP-26 characterize pyoderma gangrenosum." 06/01/2007 - "Improvement of idiopathic pyoderma gangrenosum during treatment with anti-tumor necrosis factor alfa monoclonal antibody."
8.	mycophenolate mofetil (Cellcept)FDA LinkGeneric 12/01/2004 - "Mycophenolate mofetil is an effective treatment for peristomal pyoderma gangrenosum." 10/01/2013 - "Mycophenolate mofetil (MMF) has enjoyed increasing popularity as an emerging immunosuppressant treatment for various autoimmune dermatologic conditions, including pyoderma gangrenosum (PG). " 10/01/2013 - "Treatment of pyoderma gangrenosum with mycophenolate mofetil as a steroid-sparing agent." 06/06/2011 - "Mycophenolate mofetil therapy resulted in complete resolution of her pyoderma gangrenosum. " 07/01/2009 - "Mycophenolate mofetil may be beneficial as an immunomodulatory agent in selected patients with pyoderma gangrenosum. "
9.	Intravenous Immunoglobulins (IVIG)FDA Link 12/01/2007 - "To elucidate the efficacy of IVIG as an adjunct treatment for pyoderma gangrenosum (PG). " 01/01/1995 - "Efficacy of human intravenous immune globulin in pyoderma gangrenosum." 05/01/2012 - "We report a case of a patient with an aggravation of preknown pyoderma gangrenosum during pregnancy who was successfully treated with intravenous immunoglobulins. " 05/01/2012 - "Successful treatment of pyoderma gangrenosum with intravenous immunoglobulins during pregnancy." 01/01/2006 - "Pyoderma gangrenosum treated with high-dose intravenous immunoglobulins: Two cases and review of the literature."
10.	Cyclophosphamide (Cytoxan)FDA LinkGeneric 04/01/1997 - "To evaluate the potential efficacy of intravenous bolus cyclophosphamide (IVCY) in patients with pyoderma gangrenosum. " 04/01/1997 - "Intravenous cyclophosphamide pulses in pyoderma gangrenosum: an open trial." 07/01/1994 - "We conclude that pulse cyclophosphamide is another possible therapy for pyoderma gangrenosum." 08/01/1967 - "Pyoderma gangrenosum with response to cyclophosphamide therapy." 03/01/1999 - "Plasmapheresis and cyclophosphamide as successful treatments for pyoderma gangrenosum."

Therapies and Procedures

1.	Blood Component Removal (Apheresis) 10/01/2004 - "Accordingly, a recent study reported the remission of pyoderma gangrenosum following the reduction of activated peripheral blood GM by adsorptive apheresis (GMA). " 06/01/2007 - "Efficacy of granulocyte and monocyte adsorption apheresis for three cases of refractory pyoderma gangrenosum." 12/01/2008 - "Leukocyte adsorption apheresis for the treatment of pyoderma gangrenosum." 08/01/2005 - "Treatment of pyoderma gangrenosum with granulocyte and monocyte adsorption apheresis." 08/01/2002 - "Granulocyte and monocyte adsorption apheresis for pyoderma gangrenosum."
2.	Drug Therapy (Chemotherapy) 08/01/1985 - "Despite the less penetrating nature of this variant, treatment of the pyoderma gangrenosum is unsatisfactory and in the absence of effective therapy for the underlying disease, healing occurred only in the patient with acute leukaemia who achieved complete remission in response to chemotherapy." 10/01/1988 - "The spontaneous resolution of these skin lesions following discontinuation of chemotherapy suggests that these drugs may be of major significance in the aetiology of pyoderma gangrenosum. " 10/01/1988 - "Although pyoderma gangrenosum occurred during clinical remission, we cannot rule out a synergism of leukaemia and chemotherapy in its pathogenesis." 09/01/2001 - "The preoperative investigation should include pyoderma gangrenosum in the personal history and take associated diseases into account (e.g., inflammatory bowel diseases, blood diseases, rheumatological diseases and vasculitis) to provide prophylactic immunosuppressive pharmacotherapy. " 11/01/2011 - "The management of pyoderma gangrenosum often requires systemic drug therapy, such as corticosteroids, sulfones or immunosuppressants, either alone or in combination. "
3.	Transplants (Transplant) 10/01/2014 - "Acute postoperative pyoderma gangrenosum case and review of literature identifying chest wall predominance and no recurrence following skin grafts." 01/01/2011 - "[Autodermoplasty with split skin grafts in treatment of pyoderma gangrenosum]." 07/01/2010 - "Pyoderma gangrenosum of the eyelids: recurrence in a skin graft." 04/01/2010 - "Atypical pyoderma gangrenosum complicating a skin graft." 04/01/1999 - "We describe the use of split skin grafts in the management of ulcerative pyoderma gangrenosum in 4 patients. "
4.	Colectomy 11/01/1999 - "Another case received total colectomy and pyoderma gangrenosum was cured. " 02/01/2005 - "Post-colectomy peristomal pyoderma gangrenosum." 01/01/1992 - "[Peristomal pyoderma gangrenosum after colectomy for Crohn disease. " 01/01/1987 - "Pyoderma gangrenosum after colectomy for inflammatory bowel disease. " 12/01/1985 - "Treatment of pyoderma gangrenosum complicating ulcerative colitis has in the past been frustrating and usually unsuccessful, frequently resulting in colectomy. "
5.	Transplantation (Transplant Recipients) 09/01/2015 - "Pyoderma gangrenosum in a renal transplant recipient: A case report and review of literature." 12/01/2006 - "Pyoderma gangrenosum in a renal transplant recipient: a case report." 09/01/1989 - "Pyoderma gangrenosum in an allogeneic bone marrow transplant recipient." 09/01/2004 - "Treatment can further be addressed based on etiology - chemical injury (irritant contact dermatitis, pseudoverrucous lesions, and encrustations); mechanical injury (pressure/shear, stripping, mucocutaneous separation, mucosal transplantation); infection (Candidiasis, folliculitis); immunologic disorders (allergic contact dermatitis); and disease-related lesions (varices, pyoderma gangrenosum, malignancy). " 05/01/2000 - "We report a 17-year-old boy with severe pyoderma gangrenosum treated successfully with mycophenolate mofetil and autologous keratinocyte transplantation using an esterified hyluronic acid delivery system."