Cover Image
QR Code

Pyoderma Gangrenosum in Clinical Practice: Five Years of Experience from a Tertiary Referral Center.

Aim: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that causes a high wound burden. Diagnosis is difficult, and treatment is inconsistent. We aimed to describe clinical features, treatments administered, outcomes, and the safety profile of those treatments in a tertiary-center cohort....

Full description

Published in:Turkish Journal of Dermatology / Türk Dermatoloji Dergisi Vol. 20; no. 2; pp. 72 - 80
Main Authors: Gökyayla, Ece, Ünal, Simge
Format: research tables/charts Journal Article
Published: Galenos Yayinevi Tic. LTD. STI 2026
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=194399984&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 194399984
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        13077635
        87WM
      jtl: Turkish Journal of Dermatology / Türk Dermatoloji Dergisi
      issn: 13077635
      maglogo: N
    pubinfo:
      dt: 2026
      vid: 20
      iid: 2
      pid: 28155
      pub: Galenos Yayinevi Tic. LTD. STI
    artinfo:
      ui:
        194399984
        194399984
        194399984
        10.4274/tjd.galenos.2026.48278
        194399984
      ppf: 72
      ppct: 8
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: Pyoderma Gangrenosum in Clinical Practice: Five Years of Experience from a Tertiary Referral Center.
      aug:
        au:
          Gökyayla, Ece
          Ünal, Simge
        affil: Department of Dermatology and Venereology, Ege University Faculty of Medicine, İzmir, Türkiye
      sug:
        subj:
          Pyoderma Gangrenosum Symptoms
          Pyoderma Gangrenosum Drug Therapy
          Treatment Outcomes
          Patient Safety
          Tertiary Health Care
          Rare Diseases
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Prospective Studies
          Retrospective Design
          Record Review
          Mann-Whitney U Test
          Kruskal-Wallis Test
          Spearman's Rank Correlation Coefficient
          Chi Square Test
          Fisher's Exact Test
          Confidence Intervals
          Data Analysis Software
          Descriptive Statistics
          Skin Ulcer
          Lower Extremity Pathology
          Adrenal Cortex Hormones Administration and Dosage
          Administration, Topical
          Cyclosporine Therapeutic Use
          Colchicine Therapeutic Use
          Adalimumab Therapeutic Use
          Immunoglobulins, Intravenous Therapeutic Use
          Infliximab Therapeutic Use
          Wound Infection
          Sex Factors
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Aim: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that causes a high wound burden. Diagnosis is difficult, and treatment is inconsistent. We aimed to describe clinical features, treatments administered, outcomes, and the safety profile of those treatments in a tertiary-center cohort. Materials and Methods: We performed a single-center retrospective study (2020–2025). PG was diagnosed by clinicopathologic assessment using the PARACELSUS scoring system and by exclusion of mimicking conditions. Responses were predefined: [complete response (CR), ≥ 75% ulcer reduction without active inflammation or new ulcers], [partial response (PR), 30–< 75% with supportive signs], and [no response (NR), < 30% or progression]. We recorded total treatment duration (TTD) and total number of treatments (TNTs). Results: Fourteen patients were included (7 women, 7 men; mean age 53.0). The ulcerative subtype was most common (n = 12/14, 85.7%); pathergy was present in 35.7% (n = 5/14). The lower limbs were the most frequent sites (n = 5/14, 35.7%). First-line therapy consisted mainly of topical and/or systemic corticosteroids (CR 57.1%, PR 7.1%, NR 35.7%). Second-line regimens (steroids, cyclosporine, colchicine, adalimumab) resulted in CR, PR, and NR rates of 28.6%, 28.6%, and 42.9%, respectively. Third-line therapy (steroids, intravenous immunoglobulin, or cyclosporine) produced PR in all cases. Infliximab, administered as fourth-line therapy (n = 3), achieved CR in 66.7% and PR in 33.3%; one wound infection occurred. The overall TTD was 4.61 ± 4.48 months (median 3, range 1.5–18) and TNT was 1.93 ± 1.21 (median 2, range 1–4). Adverse events occurred in 35.7% of patients overall and in 44.4% of steroid-exposed patients, typically at 3 months. TTD correlated with adverse events [r = 0.74; P = 0.002; 95% confidence interval (0.34, 0.91)]. No statistically significant sex-related differences were observed in treatment response distribution, TTD, or TNT (P > 0.05); however, descriptive trends suggested that females tended toward longer TTD, whereas males exhibited higher TNT. Conclusion: Corticosteroids are effective, but time-dependent toxicity is common. Early steroid-sparing strategies are advisable. Infliximab showed favorable response rates in refractory PG. Structured wound care should accompany all pharmacologic treatments. Larger prospective studies are needed.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N