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: 1416 relevant articles (119 outcomes, 37 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Psoriasis (Pustulosis Palmaris et Plantaris)
2.	Ulcer
3.	Ulcerative Colitis
4.	Crohn Disease (Crohn's Disease)
5.	Atopic Dermatitis (Atopic Eczema)

Experts

1.	Ortega-Loayza, Alex G: 8 articles (03/2022 - 10/2015)
2.	Yamamoto, Toshiyuki: 7 articles (05/2022 - 03/2010)
3.	Dissemond, Joachim: 7 articles (12/2020 - 02/2011)
4.	Marzano, A V: 6 articles (06/2017 - 03/2008)
5.	Kanekura, Takuro: 5 articles (04/2022 - 08/2002)
6.	Alavi, Afsaneh: 5 articles (01/2022 - 02/2018)
7.	Kirsner, Robert S: 5 articles (06/2021 - 08/2003)
8.	Morita, Akimichi: 5 articles (01/2021 - 03/2005)
9.	Thomas, Kim S: 5 articles (01/2017 - 04/2012)
10.	Ormerod, Anthony D: 5 articles (12/2016 - 04/2012)

Drugs and Biologics

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

1.	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. " 07/01/2018 - "Herein we report a delayed diagnosis of Pyoderma gangrenosum of the penis resulting in partial damage and was effectively treated with 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."
2.	Infliximab (Remicade)FDA Link 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." 04/01/2006 - "Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial."
3.	Adrenal Cortex Hormones (Corticosteroids)IBA 10/01/2022 - "We found that the systematic use of Delphi consensus diagnostic criteria resulted in substantial changes in management patterns in cases of suspected pyoderma gangrenosum (PG), including a reduction in systemic corticosteroid use, and significantly improved clinical outcomes. " 12/01/2009 - "Pyoderma gangrenosum is effectively treated with systemic corticosteroids." 02/01/2009 - "Early diagnosis and early corticosteroid administration appeared to be effective for promoting healing of peristomal pyoderma gangrenosum." 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" 10/01/2018 - "A diagnosis of pyoderma gangrenosum eventually was made, and the condition improved with the administration of systemic corticosteroids. "
4.	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."
5.	Prednisolone (Predate)FDA LinkGeneric 09/01/2016 - "Marked improvement was achieved with prednisolone treatment, suggesting a diagnosis of pyoderma gangrenosum (PG). " 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. " 07/01/2021 - "We herein report a case of penile pyoderma gangrenosum that was successfully treated with prednisolone and by urethrocutaneostomy without penectomy. "
6.	DapsoneFDA Link 10/01/2004 - "Behçet's syndrome with pyoderma-gangrenosum-like lesions treated successfully with dapsone monotherapy." 11/01/2018 - "Evaluating the Efficacy of Topical Dapsone Treatment for Pyoderma Gangrenosum: A Retrospective Case Series." 10/01/2018 - "Efficacy of Systemic Dapsone Treatment for Pyoderma Gangrenosum: A Retrospective Review." 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. "
7.	SteroidsIBA 06/09/2010 - "Once the diagnosis of pyoderma gangrenosum was established and once appropriate treatment with steroids was initiated, her condition improved. " 06/01/2019 - "[A Case of Penile Pyoderma Gangrenosum Treated with Steroid Administration without Penectomy]." 01/01/2016 - "Ultimately she had been diagnosed as pyoderma gangrenosum and managed successfully with steroids. " 03/01/2014 - "Rapid recovery of vulvar pyoderma gangrenosum in response to aggressive surgery and steroid treatment." 03/01/2012 - "Pyoderma gangrenosum, however, can be recurrent, and early initiation of a steroid-sparing agent is prudent. "
8.	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." 05/01/2023 - "Small case series and case reports suggest a role for IVIG in the management of refractory pyoderma gangrenosum (PG). " 05/01/2023 - "Intravenous immunoglobulin treatment for refractory pyoderma gangrenosum." 11/01/2020 - "Successful treatment of severe refractory post-cesarean pyoderma gangrenosum with intravenous immunoglobulin."
9.	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." 10/20/2021 - "Low Serum Tumor Necrosis Factor-α Antagonist Concentrations in Patients With Inflammatory Bowel Disease Who Achieve Healing From Pyoderma Gangrenosum."
10.	Mycophenolic Acid (Cellcept)FDA LinkGeneric 12/01/2004 - "Mycophenolate mofetil is an effective treatment for peristomal pyoderma gangrenosum." 10/01/2022 - "Recalcitrant vulvar pyoderma gangrenosum successfully treated with mycophenolate mofetil." 12/01/2021 - "A systematic MEDLINE (PubMed) review was performed of articles containing linked keywords: "mycophenolate mofetil" and "pyoderma gangrenosum". " 12/01/2021 - "Institutional review board approval was obtained to review patients from a single institution who received mycophenolate mofetil for pyoderma gangrenosum between January 1, 2010, and December 31, 2019. " 10/01/2010 - "Effectiveness of mycophenolic acid in refractory pyoderma gangrenosum."

Therapies and Procedures

1.	Therapeutics 10/01/2015 - "Early recognition of patients at risk for pyoderma gangrenosum, the necessity to improve its early diagnosis, and the future outlook of targeted and personalized therapies relies on the improved comprehension of the complex pathogenesis of pyoderma gangrenosum. " 05/01/1991 - "The unusual association of these disorders is reviewed, and the efficacy of pulse therapy in the treatment of refractory cases of pyoderma gangrenosum is discussed." 07/01/2005 - "This study was designed to evaluate the presentation, management, and outcome of peristomal pyoderma gangrenosum at a specialist colorectal unit and develop a strategy for therapy. " 08/01/2023 - "Pyoderma gangrenosum currently lacks standardized therapy. " 06/01/2021 - "Evidence to support available therapies for pyoderma gangrenosum (PG) is limited. "
2.	Blood Component Removal (Apheresis) 02/01/2017 - "To the best of our knowledge, this is the first report on the efficacy of granulocyte and monocyte adsorption apheresis in pyoderma gangrenosum in Europe." 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." 04/01/2022 - "Granulocyte and monocyte adsorptive apheresis for pyoderma gangrenosum." 02/01/2017 - "Successful treatment of pyoderma gangrenosum with granulocyte and monocyte adsorption apheresis."
3.	Negative-Pressure Wound Therapy 01/01/2022 - "Negative-pressure wound therapy has been shown to be effective in re-epithelialisation in recalcitrant pyoderma gangrenosum. " 01/01/2023 - "Use of negative pressure wound therapy to successfully treat postoperative pyoderma gangrenosum following laparoscopic surgery: a case report." 01/01/2022 - "A case report of intractable pyoderma gangrenosum treated with negative-pressure wound therapy." 01/01/2022 - "Negative-pressure wound therapy as an adjunct to treating pyoderma gangrenosum." 10/01/2021 - "Non-surgical Management of Complex Refractory Pyoderma Gangrenosum With Negative Pressure Wound Therapy With Instillation."
4.	Drug Therapy (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." 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." 11/01/2020 - "Colorectal carcinoma, chemotherapy and peristomal pyoderma gangrenosum. " 04/01/2020 - "Successful Mastectomy and Chemotherapy in a Patient with Breast Cancer and Active Generalized Pyoderma Gangrenosum."
5.	Transplantation 05/01/2023 - "The treatment of VSD combined with flap transplantation and immunosuppressive agent treatment promote ulcer wound healing of pyoderma gangrenosum." 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." 05/01/2023 - "Clinical efficacy of flap transplantation combined with vacuum sealing drainage and methylprednisolone and cyclosporine in the treatment of pyoderma gangrenosum." 05/01/2000 - "Treatment of recalcitrant ulcers in pyoderma gangrenosum with mycophenolate mofetil and autologous keratinocyte transplantation on a hyaluronic acid matrix."