A Rationale for Adjuvant Surgical Intervention in Pyoderma Gangrenosum

Kaddoura, Imad L.; Amm, Christian A. El

doi:10.1097/00000637-200101000-00005

Cited by 62 publications

(47 citation statements)

References 29 publications

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“…Azathioprine [4, 58, 59], methotrexate [60], tacrolimus [61,62,63,64], thalidomide [65], dapsone [66, 67], mycophenolate mofetil [68], cyclophosphamide [69] and colchicine [70] have shown some effectiveness in case reports. Surgical procedures such as debridement should be avoided, since they may cause extension of the lesions and further tissue damage [71, 72]. Skin graft [73, 74], intravenous immunoglobulin [75] or plasmapheresis [76] have been useful in isolated cases.…”

Section: Discussionmentioning

confidence: 99%

Infliximab for the Treatment of Disseminated Pyoderma Gangrenosum Associated with Ulcerative Colitis

Juillerat¹,

Christen-Zäch

Troillet³

et al. 2007

Dermatology

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We report the case of a 19-year-old woman who developed an acute disseminated pyoderma gangrenosum (PG) during a severe flare of ulcerative colitis (UC). She was successfully treated with a 3-dose regimen of the anti-tumor-necrosis-factor-α antibody infliximab. The literature on the effectiveness of this biological agent was reviewed, including 8 other cases of UC-associated PG and 77 cases of Crohn’s-disease-associated PG. This case report and the review of the literature demonstrate that infliximab can be successfully used to treat patients with PG associated with inflammatory bowel diseases.

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Section: Discussionmentioning

confidence: 99%

Infliximab for the Treatment of Disseminated Pyoderma Gangrenosum Associated with Ulcerative Colitis

Juillerat¹,

Christen-Zäch

Troillet³

et al. 2007

Dermatology

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“…Measures directed at cleaning the ulcer and preventing bacterial overgrowth are, however, important. More invasive surgical debridement should be discouraged as it may trigger new lesions (pathergy) [41,42,43]. …”

Section: Treatmentmentioning

confidence: 99%

Extraintestinal Manifestations of Crohn’s Disease

et al. 2005

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In each case of extraintestinal manifestations of Crohn’s disease, active disease, if present, should be treated to induce remission, which may positively influence the course of most concomitant extraintestinal manifestations. For some extraintestinal manifestations, however, a specific treatment should be introduced. This latter part of disease management will be discussed in this chapter, in particular for pyoderma gangrenosum, uveitis, spondylarthropathy – axial arthropathy – and primarysclerosing cholangitis, which have also been described in quiescent Crohn’s disease. Few new drugs for the treatment of extraintestinal manifestations of Crohn’s disease have been developed in the past and only the role of infliximab has increased in Crohn’s disease-related extraintestinal manifestations. Drugs specifically aimed at this treatment, stemming from a few randomized controlled studies or case series, are sulfasalazine, 5-ASA, corticosteroids, azathioprine or 6-mercaptopurine, methotrexate, infliximab, dapsone and cyclosporine or tacrolimus.

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“…El debridamiento simple y uso de injerto sobre las úlceras ha sido usado, pero con resultados que pueden ser desalentadores e incluso puede exacerbar la enfermedad i ; por otro lado, el manejo conservador lleva a cierre por segunda intención con importantes secuelas cicatriciales [10][11][12] . Si se prefiere optar por la alternativa quirúrgica, existen tres recomendaciones: primero, siempre usar terapia inmunosupresora preoperatoria y mantenerla por al menos 6 meses postoperatoria 21 ; segundo, evitar usar suturas epidérmicas, preferir cintas adhesivas, de esta forma se podría prevenir el desarrollo de PG en el sitio de sutura 22 ; tercero, si está considerando el uso de injertos, preferir aloinjertos con cobertura esteroidal para minimizar el dolor y favorecer la cicatrizacion 3 .…”

Section: Discussionunclassified

Pioderma gangrenoso en mamoplastía de reducción con pedículo inferior

et al. 2013

Rev Chil Cir

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Pyoderma gangrenosum secondary to reduction mammoplasty Background: Pyoderma gangrenosum (PG) is an uncommon inflammatory and ulcerative disorder of the skin. It may be associated with immune deficiencies. It is usually located in the extremities and its appearance after reduction mammoplasty is exceptional. We report three patients with the disease. A 54 years old female subjected to a bilateral reduction mammoplasty with an inferior pedicle. She developed a pyoderma gangrenosum and was treated with systemic steroids and local application of Dapsone with remission of lesions and healing after one month of evolution. A 23 years old women subjected to the same surgical procedure, which developed a wound dehiscence with ulcerative lesions, was treated with steroids and Azathioprine, reducing the local inflammation but leaving a severe esthetic sequel. A 21 years old woman subjected to the same surgical procedure, develop bilateral wound dehiscence and ulcerative lesions, she was treated with steroids and antimicrobials achieving a secondary healing.

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A Rationale for Adjuvant Surgical Intervention in Pyoderma Gangrenosum

Cited by 62 publications

References 29 publications

Infliximab for the Treatment of Disseminated Pyoderma Gangrenosum Associated with Ulcerative Colitis

Infliximab for the Treatment of Disseminated Pyoderma Gangrenosum Associated with Ulcerative Colitis

Extraintestinal Manifestations of Crohn’s Disease

Pioderma gangrenoso en mamoplastía de reducción con pedículo inferior

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