A Comprehensive Review of Local Pharmacologic Therapy for Pyoderma Gangrenosum

Pyoderma gangrenosum (PG) is a rare, ulcerative inflammatory skin disease that most commonly occurs in patients with inflammatory bowel disease, rheumatologic diseases, or hematologic diseases. Successful treatment of PG often requires immunosuppression and appropriate wound care. Systemic corticosteroids and cyclosporine are the first-line treatments for PG. However, chronic use of these systemic agents places patients at risk for developing significant side effects, including hyperglycemia, osteoporosis, hypertension, and weight gain. Furthermore, when treating small or superficial PG ulcers, the use of local agents as monotherapies or adjuvant treatments can be ideal to control inflammation and promote healing without placing the patient at risk for many severe side effects that can be seen with long-term use of systemic agents. This literature review assesses all available local therapies in order to summarize the use and reported efficaciousness of the broad range of local treatments available for PG.