Successful Treatment of Ulcerative-Type Pyoderma Gangrenosum with a Combination Therapy of Oral Prednisolone, Vacuum-Assisted Closure, and Skin Grafting

• Main Authors: Hiroyuki Goto (Author), Yoshimoto Okada (Author), Seimi Watanabe (Author), Kanako Danno (Author), Shinya Yamamoto (Author), Ryohei Ishiura (Author), Yuichi Nakayama (Author), Kohei Mitsui (Author), Ayaka Ueki (Author), Yasuo Nakai (Author), Mitsunaga Narushima (Author), Keiichi Yamanaka (Author)
• Format: Book
• Published: Karger Publishers, 2021-10-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Pyoderma gangrenosum (PG) is a relatively rare inflammatory skin disease that progressively causes necrotic ulceration mainly on the lower extremities and trunk. Systemic corticosteroid is considered a first-line treatment for PG as it facilitates wound healing; however, several cases where tumor necrosis factor-α inhibitors, adalimumab and infliximab, were administered showed good response. For intractable PG with a large ulcer or problematic epithelization, chemical or mechanical debridement of necrotic tissue in combination with skin grafting may be necessary to promote wound healing. Our report presents a case of intractable ulcerative PG requiring oral prednisolone and skin grafting. Although mechanical debridement was performed, granulation was poor; therefore, after the PG activity became quiescent, we utilized a vacuum-assisted closure (VAC) system to promote granulation and adaptation of the grafted skin. Although more cases are required for a definitive conclusion, the VAC system may be a choice for PG with large ulcers.

Item Description

1662-6567
10.1159/000519659