Background: Pyoderma gangrenosum is a neutrophilic
dermatosis of unknown
etiology , with inconstant systemic
associations and a variable
prognosis .
Aims: To study the clinical features and systemic
associations of
pyoderma gangrenosum and its response to
treatment .
Methods: All
patients diagnosed to have
pyoderma gangrenosum at the
dermatology department of the
Government Medical College, Kozhikode, from January 01, 2005 to December 31, 2014 were included in this
prospective study .
Results: During the 10-year study period, 61
patients were diagnosed to have
pyoderma gangrenosum . A
male predilection was noted. The most common clinical type was ulcerative
pyoderma gangrenosum (90.2%). More than 60% of
patients had lesions confi ned to the
legs ; 78.7% had a single lesion and 27.9% had systemic
associations . Most
patients required systemic
steroids .
Patients with
disease resistant to
steroid therapy were treated with
intravenous immunoglobulin G and split-thickness
skin grafts under
immunosuppression induced by
dexamethasone pulse therapy . All except one
patient attained complete
disease resolution.
Limitations: The main limitation of our study was the small
sample size .
Conclusions: The
male predilection documented by us was contrary to most previous studies. We found split-thickness
skin graft to be a useful option in resistant cases. More
prospective studies may enable the formulation of better diagnostic criteria for
pyoderma gangrenosum and improve its management.