Application of cold atmospheric plasma in pyoderma gangrenosum: a pilot study

The application of cold atmospheric plasma (CAP) has been described as a promising therapeutic approach for wound healing. Its use in immunologically mediated wounds such as pyoderma gangrenosum (PG) has not yet been sufficiently investigated. This pilot study aimed to evaluate the efficacy, tolerability, patient preferences, and patient-reported outcomes of CAP in PG.

This monocentric, open-label, randomised and controlled pilot study included patients with PG. The treatment phase lasted 12 weeks, with two CAP treatments per week (for patients in the treatment group (TG), versus patients in the control group (CG) who received standard of care only) and five documented study visits. Effects on wound status and patient experience-including pain reduction, improvement in quality of life, and perceived treatment benefit-were assessed.

Both the TG and the CG comprised 10 patients each. In the TG, a statistically significant reduction in fibrin coatings was observed between Visit 1 and Visit 5 (z=-2.060; p<0.025; n=6; d=0.84). While not statistically significant under the predefined threshold (a=0.025), necrosis showed a trend toward reduction (p=0.039). A significant reduction in pain was also observed between Visit 1 and Visit 5 in the TG (z=-2.03; p<0.025; n=5; d=0.91).

The results of this pilot study suggest that CAP is a safe and well tolerated treatment option for PG, and may reduce wound pain over the course of treatment. There is evidence that CAP may have a beneficial effect on the status of the wound in PG. Double-blinded randomised controlled trials, including larger cohorts and outcome-oriented randomisation, are needed to further clarify the therapeutic potential of CAP in PG.