Pyoderma Gangrenosum Follow-up

  • Author: J Mark Jackson, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Mar 23, 2010
 

Further Outpatient Care

  • Patients with pyoderma gangrenosum (PG) should receive follow-up care on a regular basis to monitor the drug therapy and to measure the size of the lesion or lesions. Multiple methods of wound care are available.
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Inpatient & Outpatient Medications

  • Therapy with corticosteroids is often prescribed initially. Sometimes, an immunosuppressive agent is also initiated later or simultaneously, particularly in those patients for whom high-dose long-term therapy is anticipated. Some physicians select cyclosporine as the initial therapy. The TNF inhibitors are showing promise in the treatment of pyoderma gangrenosum.
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Transfer

  • Care of the patient with pyoderma gangrenosum is often referred from the general dermatologist to tertiary centers where such patients are seen more frequently.
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Prognosis

  • The prognosis of pyoderma gangrenosum is generally good; however, recurrences may occur, and residual scarring is common.
  • Many patients with pyoderma gangrenosum improve with initial immunosuppressive therapy and require minimal care afterwards; however, many patients follow a refractory course and multiple therapies fail. These patients pose a difficult clinical problem that requires frequent follow-up and long-term care.
  • Some patients demonstrate pathergy, and, in such instances, protection of the skin from trauma may prevent a recurrence.
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Contributor Information and Disclosures
Author

J Mark Jackson, MD  Clinical Professor of Medicine/Dermatology, Division of Dermatology, University of Louisville

J Mark Jackson, MD is a member of the following medical societies: American Academy of Dermatology, American Acne and Rosacea Society, American Medical Association, Kentucky Medical Association, and Texas Medical Association

Disclosure: abbott, Amgen, Centocor Honoraria Speaking and teaching

Coauthor(s)

Jeffrey P Callen, MD  Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine

Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and American College of Rheumatology

Disclosure: Amgen Honoraria Consulting; Abbott Honoraria Consulting; Electrical Optical Sciences Consulting fee Consulting; Celgene Honoraria Safety Monitoring Committee; GSK - Glaxo Smith Kline Consulting fee Consulting; TenXBioPharma Consulting fee Safety Monitoring Committee

Specialty Editor Board

David P Fivenson, MD  Associate Director, St Joseph Mercy Hospital Dermatology Program, Ann Arbor, Michigan

David P Fivenson, MD is a member of the following medical societies: American Academy of Dermatology, Medical Dermatology Society, Michigan Dermatological Society, Michigan State Medical Society, Photomedicine Society, Society for Investigative Dermatology, and Wound Healing Society

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Warren R Heymann, MD  Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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Classic or typical pyoderma gangrenosum. This patient did not have an associated disease, and the condition responded well to cyclosporine.
Atypical pyoderma gangrenosum.
Peristomal pyoderma gangrenosum.
Factitial ulceration on scalp from chronic manipulation mimicking an ulceration of pyoderma gangrenosum.
 
 
 
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