Treatment of Pyoderma Gangrenosutn with Cultured Keratinocyte Autografts

BACKGROUND: Pyoderma gangrenosum is an uncommon chronic skin disease characterized by rapidly enlarging cutaneous ulcers. Immunosuppressive agents, such as corticosteroids, are the mainstay of therapy. OBJECTIVE: We describe a patient with pyoderma gangrenosum treated with cultured keratinocyte autografts for a full-thickness ulcer located on the dorsal and lateral aspects of the foot. METHODS: After stabilizing the ulcer with intralesional and systemic corticosteroids, the ulcer was debrided and cultured keratinocyte autografts were secured with nylon mesh. An outer dressing of gauze and elastic bandage was used. RESULTS: The patient had > 95% "take" of the grafts and the ulcer was fully healed in less than 1 month. The grafted area preserved the clinical phenotype of the palmar skin from which the original biopsy was taken. CONCLUSION: Cultured keratinocyte autografts can provide permanent wound coverage for patients on high doses of immunosuppressive medications.