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[Multimodal therapy for peristomal pyoderma gangrenosum with topical cyclosporine]

Anastasia S Vollmer1, Martin Hartmann2, Ferdinand Toberer2

  • 1Universitäts-Hautklinik Heidelberg, Ruprecht-Karls Universität Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Deutschland. Anastasia.Vollmer@med.uni-heidelberg.de.

Dermatologie (Heidelberg, Germany)
|July 3, 2023
PubMed

Insights

Pyoderma gangrenosum (PG) is a rare neutrophilic skin disease. A multimodal therapy combining topical cyclosporine, hydrocolloid dressings, and systemic glucocorticoids effectively treated two challenging peristomal PG cases.

Area of Science:

  • Dermatology
  • Immunology
  • Wound Healing

Context:

  • Pyoderma gangrenosum (PG) is a rare, ulcerative neutrophilic dermatosis.
  • Peristomal PG presents unique challenges due to mechanical irritation, often leading to treatment resistance.
  • Current treatment strategies for peristomal PG require further investigation for optimal outcomes.

Purpose:

  • To present a multimodal therapeutic strategy for managing recalcitrant peristomal pyoderma gangrenosum.
  • To illustrate the efficacy of topical cyclosporine, hydrocolloid dressings, and systemic glucocorticoids in two distinct cases.

Summary:

  • Two cases of peristomal pyoderma gangrenosum (PG) resistant to conventional treatments were managed with a combined approach.
  • The multimodal therapy included topical cyclosporine, hydrocolloid dressings for wound protection, and systemic glucocorticoids.
  • One patient achieved complete re-epithelialization within 7 weeks, while the other experienced significant wound edge downsizing over 5 months.

Impact:

  • This therapeutic concept offers a promising strategy for managing difficult-to-treat peristomal pyoderma gangrenosum.
  • The findings may guide clinicians in developing personalized treatment plans for patients with refractory PG.
  • Successful management of peristomal PG can improve patient quality of life by reducing pain and promoting wound closure.
Keywords:
Hydrocolloid dressingImmunosuppressionNeutrophilic diseaseSystemic glucocorticoidUlceration

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