Recalcitrant pyoderma gangrenosum--two cases successfully treated with cyclosporin A

Area of Science:

• Immunology
• Dermatology
• Rheumatology

Background:

• Cyclosporin A (CSA) is a well-established immunosuppressant primarily used in organ transplantation.
• Recent research indicates CSA's potential in treating autoimmune skin disorders.
• Pyoderma gangrenosum (P.G.) is a rare, severe neutrophilic dermatosis with limited treatment options.

Observation:

• Two cases of recalcitrant pyoderma gangrenosum (P.G.) are presented.
• Both P.G. cases were associated with rheumatoid arthritis (R.A.).
• Patients presented with severe, treatment-resistant skin ulcerations.

Findings:

• Low-dose cyclosporin A (CSA) treatment led to significant improvement in both P.G. cases.
• CSA demonstrated efficacy in managing severe P.G. refractory to other therapies.
• The treatment was well-tolerated, suggesting a favorable safety profile.

Implications:

• Low-dose CSA may be a viable therapeutic option for recalcitrant pyoderma gangrenosum.
• This approach could be particularly beneficial for P.G. patients with co-existing rheumatoid arthritis.
• Further research is warranted to establish optimal dosing and long-term outcomes of CSA in P.G.