Pyoderma Gangrenosum Fails Initial Treatment Plans

In these images, we feature a case of pyoderma gangrenosum that failed antibiotics, steroids, other immunosuppressive agents, thalidomide and cyclosporine. Pyoderma gangrenosum is a rare skin ulcer with a pathogenesis that is not yet fully understood, although it is believed to have an immune-related connection. It is frequently associated with rheumatic diseases, inflammatory bowel diseases(IBDs), and endocrine and hematologic disorders.It often responds to systemic corticosteroid therapy, but in this case, it did not. This patient lived with the condition for years, until a successful round of active IVIG treatment. Her immune response has been described as "remarkable."  

References:

Angela Ehling, Sigrid Karrer, et al.

"Therapeutic Management of Pyoderma Gangrenosum,"

Arthritis and Rheumatism. Oct. 8, 2004. DOI 10.1002/art.20559  Finja Jockenhofer, Katharina Herberger, et al.

"Tricenter analysis of cofactors and comorbidity in patients with pyoderma gangrenosum,"

JDDG. Oct. 21, 2016. DOI: 10.1111/ddg.12791