Clinical outcomes and response of patients applying topical therapy for pyoderma gangrenosum: A prospective cohort study.
Background: Pyoderma gangrenosum (PG) is an uncommon dermatosis with a limited evidence base for treatment.Objective: We sought to estimate the effectiveness of topical therapies in the treatment of patients with PG.Methods: This was a prospective cohort study of UK secondary care patients with a cl...
| Publicado en: | Journal of the American Academy of Dermatology Vol. 75; no. 5; pp. 940 - 950 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Elsevier B.V.
Nov2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118813335&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 118813335 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01909622 1ZF jtl: Journal of the American Academy of Dermatology issn: 01909622 maglogo: N pubinfo: dt: Nov2016 vid: 75 iid: 5 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 118813335 118813335 NLM27502313 10.1016/j.jaad.2016.06.016 NLM27502313 118813335 ppf: 940 ppct: 10 formats: tig: atl: Clinical outcomes and response of patients applying topical therapy for pyoderma gangrenosum: A prospective cohort study. aug: au: Thomas, Kim S. Ormerod, Anthony D. Craig, Fiona E. Greenlaw, Nicola Norrie, John Mitchell, Eleanor Mason, James M. Johnston, Graham A. Wahie, Shyamal Williams, Hywel C. affil: Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom sug: subj: Antiinflammatory Agents Therapeutic Use Dermatologic Agents Therapeutic Use Pyoderma Gangrenosum Drug Therapy Treatment Outcomes Skin Ulcer Drug Therapy Medication Compliance Skin Ulcer Etiology Antiinflammatory Agents Administration and Dosage Adult Recurrence Male Pyoderma Gangrenosum Complications Dermatologic Agents Administration and Dosage Quality of Life Aged Female Tacrolimus Therapeutic Use Middle Age Prospective Studies Administration, Transcutaneous Tacrolimus Administration and Dosage Ferrans and Powers Quality of Life Index Scales Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Male Female ab: Background: Pyoderma gangrenosum (PG) is an uncommon dermatosis with a limited evidence base for treatment.Objective: We sought to estimate the effectiveness of topical therapies in the treatment of patients with PG.Methods: This was a prospective cohort study of UK secondary care patients with a clinical diagnosis of PG that was suitable for topical treatment (recruited between July 2009 and June 2012). Participants received topical therapy after normal clinical practice (primarily topical corticosteroids [classes I-III] and tacrolimus 0.03% or 0.1%). The primary outcome was speed of healing at 6 weeks. Secondary outcomes included the following: proportion healed by 6 months; time to healing; global assessment; inflammation; pain; quality of life; treatment failure; and recurrence.Results: Sixty-six patients (22-85 years of age) were enrolled. Clobetasol propionate 0.05% was the most commonly prescribed therapy. Overall, 28 of 66 (43.8%) ulcers healed by 6 months. The median time to healing was 145 days (95% confidence interval, 96 days to ∞). Initial ulcer size was a significant predictor of time to healing (hazard ratio, 0.94 [95% confidence interval, 0.88-1.00); P = .043). Four patients (15%) had a recurrence.Limitations: Our study did not include a randomized comparator.Conclusion: Topical therapy is potentially an effective first-line treatment for PG that avoids the possible side effects associated with systemic therapy. It remains unclear whether more severe disease will respond adequately to topical therapy alone. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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