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Ann Rheum Dis 63:888-889 doi:10.1136/ard.2003.016824
  • Letter

Combined therapy for pyoderma gangrenosum

  1. A P Rozin1,
  2. A Balbir-Gurman1,
  3. L Gilead2,
  4. D Slodownik2
  1. 1B Shine Department of Rheumatology, Rambam Medical Centre and B Rappaport Faculty of Medicine, Israel-Technion Institute of Technology, Haifa, Israel
  2. 2Department of Dermatology, Hadassah Medical Centre, Jerusalem, Israel
  1. Correspondence to:
    Dr A P Rozin
    Bat Galim, Rambam Medical Centre, PO Box 9602 Haifa, Israel, 31096; a_rozinrambam.health.gov.il
  • Accepted 3 November 2003

We report a case of successful combined therapy for rapidly progressive pyoderma gangrenosum (PG). A 78 year old woman was admitted to the department of rheumatology with large right leg skin ulcers affecting the anterior and mediolateral lower shin region (fig 1A). The lesions had developed from small pustules to a focus of large painful skin damage during the past month. Her past history was free of any skin disease. Arterial hypertension, depression, and osteoporosis were controlled with permanent treatment. Her laboratory findings were unremarkable, including negative hepatitis B surface antigen and hepatitis C virus and normal liver function.

Figure 1

 (A) Large ulcers of pyoderma gangrenosum with an irregular, well defined, undermined, partially raised violaceous border on admission. (B) Complete healing of the wound after combined prednisone-cyclosporin A-pulse cyclophosphamide …