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Intravenous immunoglobulin as salvage therapy in refractory pyoderma gangrenosum: report of a case and review of the literature.

Cafardi J, Sami N - Case Rep Dermatol (2014)

Bottom Line: Pyoderma gangrenosum is a neutrophilic dermatosis that occurs both as a primary disorder as well as secondary to an underlying disease.Due to its low prevalence there are limited data on therapeutics, particularly in refractory cases.Here, we discuss a case successfully managed with intravenous immunoglobulin and review the supporting literature.

View Article: PubMed Central - PubMed

Affiliation: University of Cincinnati and The Christ Hospital, Cincinnati, Ohio, Ala., USA.

ABSTRACT
Pyoderma gangrenosum is a neutrophilic dermatosis that occurs both as a primary disorder as well as secondary to an underlying disease. Due to its low prevalence there are limited data on therapeutics, particularly in refractory cases. Here, we discuss a case successfully managed with intravenous immunoglobulin and review the supporting literature.

No MeSH data available.


Related in: MedlinePlus

PG lesion post IVIG therapy.
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Figure 2: PG lesion post IVIG therapy.

Mentions: A 36-year-old woman presented with a 12 × 6 cm ulcer on her right leg (fig. 1). She stated that it had been present for 8 years and denied any history of malignancy, ulcerative colitis or rheumatic disease. Biopsy was diagnostic of pyoderma gangrenosum (PG) and prednisone 40 mg daily was initiated. Due to incomplete response, she required several steroid-sparing agents, including dapsone, methotrexate, cyclosporine, mycophenolate, infliximab, adalimumab and azathioprine. Despite this, the ulcers persisted and the prednisone could not be tapered below 20 mg daily. Intravenous immunoglobulin (IVIG) at 2 g/kg monthly was initiated with nearly complete improvement (fig. 2). The prednisone was tapered to 5 mg daily and IVIG was tapered to 2 g/kg every 12 weeks. She has since done well on azathioprine and low-dose prednisone and has had no recurrent lesions.


Intravenous immunoglobulin as salvage therapy in refractory pyoderma gangrenosum: report of a case and review of the literature.

Cafardi J, Sami N - Case Rep Dermatol (2014)

PG lesion post IVIG therapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4255992&req=5

Figure 2: PG lesion post IVIG therapy.
Mentions: A 36-year-old woman presented with a 12 × 6 cm ulcer on her right leg (fig. 1). She stated that it had been present for 8 years and denied any history of malignancy, ulcerative colitis or rheumatic disease. Biopsy was diagnostic of pyoderma gangrenosum (PG) and prednisone 40 mg daily was initiated. Due to incomplete response, she required several steroid-sparing agents, including dapsone, methotrexate, cyclosporine, mycophenolate, infliximab, adalimumab and azathioprine. Despite this, the ulcers persisted and the prednisone could not be tapered below 20 mg daily. Intravenous immunoglobulin (IVIG) at 2 g/kg monthly was initiated with nearly complete improvement (fig. 2). The prednisone was tapered to 5 mg daily and IVIG was tapered to 2 g/kg every 12 weeks. She has since done well on azathioprine and low-dose prednisone and has had no recurrent lesions.

Bottom Line: Pyoderma gangrenosum is a neutrophilic dermatosis that occurs both as a primary disorder as well as secondary to an underlying disease.Due to its low prevalence there are limited data on therapeutics, particularly in refractory cases.Here, we discuss a case successfully managed with intravenous immunoglobulin and review the supporting literature.

View Article: PubMed Central - PubMed

Affiliation: University of Cincinnati and The Christ Hospital, Cincinnati, Ohio, Ala., USA.

ABSTRACT
Pyoderma gangrenosum is a neutrophilic dermatosis that occurs both as a primary disorder as well as secondary to an underlying disease. Due to its low prevalence there are limited data on therapeutics, particularly in refractory cases. Here, we discuss a case successfully managed with intravenous immunoglobulin and review the supporting literature.

No MeSH data available.


Related in: MedlinePlus