Clinical factors influencing the response to intravenous immunoglobulin treatment in cases of treatment-resistant pyoderma gangrenosum

Haag, Carter; Ortega‐Loayza, Alex G.; Latour, Emile; Keller, Jacob B.; Fett, Nicole

doi:10.1080/09546634.2019.1606888

Cited by 18 publications

(20 citation statements)

References 12 publications

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“…IVIG has been used as an adjunctive strategy for treatment-refractive PG, most commonly as a combination therapy with systemic steroids. One study found that patients with solitary PG lesions are more responsive to IVIG than those with two or more lesions whereas factors such as ulcer location had no meaningful significance 47 . The majority of patients showed clinical improvement, and 53% of these individuals had complete resolution.…”

Section: Treatmentmentioning

confidence: 99%

Recent advances in managing and understanding pyoderma gangrenosum

2019

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Pyoderma Gangrenosum (PG) is a rare neutrophilic dermatosis with multiple different clinical presentations and associated comorbidities. PG has historically been a challenging disorder to diagnose, leading to the development of new diagnostic criteria rather than the traditional approach of a diagnosis of exclusion. The pathophysiology is thought to involve both innate and adaptive immune system dysregulation, neutrophilic abnormalities, environmental, and genetic factors. As of today, no gold standard therapy exists for the treatment of PG, and the literature is restricted to mainly case reports, case series, and 2 small randomized clinical trials. Topical, systemic, and biologic therapy, as well as adequate analgesia and proper wound care all play a role in the management of PG. Recent studies have identified additional cytokines and signalling cascades thought to be involved in the pathogenesis of PG, ultimately leading to the development of new targeted therapies. This review will focus on recent advances in the pathophysiology, clinical presentation and associated comorbidities, diagnosis, and management of PG.

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Section: Treatmentmentioning

confidence: 99%

Recent advances in managing and understanding pyoderma gangrenosum

2019

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“…13 A recent review of the limited cases of PG treated with IVIG revealed that a solitary PG lesion and absence of underlying conditions seemed to be predictors of a good response to IVIG therapy. 5 Our case suggests that IVIG may be an important therapeutic option in resistant postpartum PG, even with multiple severe ulcers, in which first-line agents such as systemic glucocorticoids, systemic cyclosporine, and other immunomodulatory agents have failed or led to complications. However, IVIG infusion is less suitable for use as a first-line agent due to its cost.…”

Section: Discussionmentioning

confidence: 84%

“…However, IVIG infusion is less suitable for use as a first-line agent due to its cost. 5 F I G U R E 4 A, Hematoxylin-Eosin section (×20) showing ulceration and intense neutrophilic and lymphocytic infiltration in the dermis. B, Perivascular and intramural neutrophilic and lymphocytic infiltration (×100)…”

Section: Discussionmentioning

confidence: 99%

“…4 Systemic corticosteroids or cyclosporine are used as first-line treatments, while various immunosuppressive agents can be used as second-line drugs. 5 Treatment regimens for refractory cases, however, are not standardized. 6 Intravenous immunoglobulin (IVIG) has been used as an emerging treatment option for PG in different clinical contexts, as reported in some small case reports and series.…”

Section: Introductionmentioning

confidence: 99%

“…6 Intravenous immunoglobulin (IVIG) has been used as an emerging treatment option for PG in different clinical contexts, as reported in some small case reports and series. 5 However, responses to various PG treatments have been reported to be affected by underlying conditions. 7 Pregnancy-and parturition-related immune changes are thought to be important factors in PG that develops after cesarean section.…”

Section: Introductionmentioning

confidence: 99%

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Successful treatment of severe refractory post‐cesarean pyoderma gangrenosum with intravenous immunoglobulin

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Gülbaşaran

Hasdemir³

et al. 2020

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Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly progressing necrolytic ulceration of the skin. Proper treatment is crucial since it can result in devastating consequences. First-line treatments include systemic corticosteroids or cyclosporine. However, no standardized treatment regimens for refractory cases exist and treatment outcomes are affected by underlying conditions. PG after

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Association between pemphigus vulgaris and pyoderma gangrenosum

Cano,

Burbano,

Rueda

2024

JEADV Clinical Practice

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Pyoderma gangrenosum (PG) is a neutrophilic dermatosis associated with certain neoplasms, predominantly of haematological origin, and autoimmune diseases. Pemphigus vulgaris (PV) is a disease in which antibodies target crucial intercellular junction components. A few cases of PG associated with PV have been described. We present a woman with a high phototype presenting this rare association and highlight the diagnostic challenge of diagnosing rare diseases in patients with high phenotypes.

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Clinical factors influencing the response to intravenous immunoglobulin treatment in cases of treatment-resistant pyoderma gangrenosum

Cited by 18 publications

References 12 publications

Recent advances in managing and understanding pyoderma gangrenosum

Recent advances in managing and understanding pyoderma gangrenosum

Successful treatment of severe refractory post‐cesarean pyoderma gangrenosum with intravenous immunoglobulin

Association between pemphigus vulgaris and pyoderma gangrenosum

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