Therapeutic management of pyoderma gangrenosum

Pyoderma gangrenosum (PG) is a primarily noninfectious inflammatory skin disease resulting in large ulcers that can spread rapidly showing undermined violaceous borders and a necrotic, purulent base. PG was first described in the 19th and early 20th centuries (1,2). Similar to Sweet’s syndrome, PG belongs to the dermatoses, which are histologically characterized by an accumulation of neutrophils without any discernible microbial pathogens. PG often develops after minor trauma, which is consistent with the phenomenon of Koebnerization, but it also occurs without a preceding injury (3–5). Owing to its numerous links to rheumatic diseases, communityand hospital-based rheumatologists are consulted regularly regarding differential diagnosis, long-term prognosis, and current treatment options. Although few controlled trials have been performed, in recent years a body of data has been accumulated from case reports and small studies including novel treatment options; this body of data has widened the therapeutic armamentarium considerably and will be discussed in detail in this review.