Eligibility Criteria for Active Ulcerative Pyoderma Gangrenosum in Clinical Trials: A Delphi Consensus on Behalf of the UPGRADE (Understanding Pyoderma Gangrenosum: Review and Assessment of Disease Effects) Group

Current landscape and future perspectives in the pathogenesis and treatment of Pyoderma gangrenosum

Pyoderma gangrenosum is a rare, ulcerative neutrophilic dermatosis of yet unknown origin. While advances have been made into the mechanisms underlying PG, our understanding is limited by a paucity of research and funding into this condition. This review highlights the current landscape of PG pathogenesis, diagnosis, and treatment in the hopes of encouraging additional scientific inquiry into this rare, severe condition.

Treatment of Pyoderma Gangrenosum

Pyoderma gangrenosum is a rare neutrophilic dermatosis that results in painful cutaneous ulcers and is frequently associated with underlying hematologic disorders, inflammatory bowel disease, or other autoimmune disorders. Pathogenesis involves an imbalance between proinflammatory and anti-inflammatory mediators, leading to tissue damage from neutrophils. First-line treatment options with the greatest evidence include systemic corticosteroids, cyclosporine, and tumor necrosis factor alpha inhibitors. Other steroid-sparing therapies such as dapsone, mycophenolate mofetil, intravenous immunoglobulin, and targeted biologic or small molecule inhibitors also have evidence supporting their use. Wound care and management of underlying associated disorders are critical parts of the treatment regimen.